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Comparison · for employers, health plans and benefits consultants

Levels vs Twin Health

Levels is a metabolic health benefit for your whole population, with a GLP-1 companion program for members on medication, backed by an IRB study of 62,236 members. Twin Health is a virtual clinic for members with type 2 diabetes, obesity or prediabetes, run by its own care team.

Talk with LevelsExplore the evidence

Decide in 20 seconds

Evidence with cohort sizes published
Levels
A benefit for your whole population
Levels
A companion program alongside existing GLP-1 coverage
Levels
Third-party validated outcomes
Twin

The short answer

Twin runs a clinic for members with a diagnosis. Levels covers the whole population, before, during and after GLP-1 therapy.

Twin Health enrolls members with type 2 diabetes, obesity or prediabetes into a virtual clinic: a device kit, an AI "digital twin," its own providers, nurses and coaches, and a stated goal of getting members off GLP-1s. Levels gives your population a metabolic health benefit scoped to what you choose to offer: proactive care for members at risk, and a GLP-1 companion program for members on therapy. The study behind it is published, limitations included. One treats the members who already qualify. The other supports metabolic health across the population, alongside existing clinicians.

Levels fits when

You want fewer eligible starts, and results that outlast the prescription

  • You want metabolic health support alongside your existing GLP-1 coverage, without changing prescribers or your PBM.
  • You need a solution for your whole population: proactive metabolic health for members at risk, and a GLP-1 companion program for members on therapy, from first dose through discontinuation.
  • You want to see the evidence. Ours is a 62,236-member IRB study, with the cohort size published next to every result.
  • You need to see GLP-1 eligibility, participation and spend at renewal, in your own numbers.

Twin Health fits when

You want a clinic built around one diagnosis

  • Your priority is remission of diagnosed type 2 diabetes, and you want a clinic built around that single goal.
  • Independent validation is a hard requirement. Twin is a Validation Institute validated provider and its Cleveland Clinic study ran in NEJM Catalyst.
  • You want a device kit shipped to every enrolled member: CGM, smart watch, smart scale and blood pressure cuff.
  • You're fine funding a program for the members who qualify and activate rather than one for everyone.

At a glance

What each one hands you.

Functionality first, price last. Twin Health entries come from their own public materials, and we say so where they publish nothing. Levels entries come from the study behind the program.

Who it covers

Levels
Every member. A wellness benefit for the whole population, plus a companion program for anyone on a GLP-1.
Twin Health
Members with type 2 diabetes, obesity, prediabetes, hypertension or PCOS who qualify and activate. Twin reports 19% of eligibles activating in year one.

Devices and data

Levels
CGM, lab panels, food logging, and sleep and activity from the member's own wearables, in the Levels app. Devices and labs are scoped to what you choose to offer.
Twin Health
CGM, smart watch, smart scale and blood pressure cuff shipped in a Twin kit. Contents vary by member.

Care team

Levels
Guidance from the care team, turned into next steps in the app. GLP-1 members also get side-effect support.
Twin Health
Twin's licensed providers, registered nurses and health coaches

GLP-1 approach

Levels
A companion program that runs alongside your existing coverage, from first dose through discontinuation. Education, nutrition and movement support, plus side-effect guidance.
Twin Health
Prescribes GLP-1s "when it's right," with a stated goal of helping members stop them. Four Rx coverage models for employers.

Who prescribes

Levels
Your PBM and your members' clinicians. Levels doesn't prescribe or manage medication.
Twin Health
Twin's providers. Medication changes go to the member's PCP by e-fax.

Published evidence

Levels
IRB-approved longitudinal study: 62,236 consented members, 1.15B glucose readings across 3.5 years. Cohort sizes and limitations published.Read the study at levels.com/pro/outcomes
Twin Health
One 2025 Cleveland Clinic study, published in NEJM Catalyst and reported through Twin's marketing. 88% stayed engaged a full year.Read the study in NEJM Catalyst

Biomarker outcomes

Levels
Among members who started out of range: 81% improved HbA1c (n=894), 79% fasting insulin (n=164), 84% triglycerides (n=370). Observational, no control arm.
Twin Health
71% lowered A1C below 6.5% without glucose-lowering meds, 27 lbs average loss, 85% off GLP-1s, 46% off insulin. Company-reported.

Below GLP-1 thresholds

Levels
At one year, 22% of members starting at BMI 30+ (n=1,102) and 33% starting at BMI 27+ with a risk factor (n=948) fell below prescribing thresholds
Twin Health
27 lbs average weight loss reported. No BMI-threshold figure published.

Independent validation

Levels
IRB-approved design, clinical review by Robert Lustig, MD. Not yet independently validated.
Twin Health
Validation Institute validated provider. Cleveland Clinic study published in NEJM Catalyst.

Security and privacy

Levels
HIPAA and SOC 2 Type 2, independently assessed
Twin Health
HIPAA compliant and SOC 2 Type 2 certified, per its security page

Reporting to you

Levels
GLP-1 eligibility, participation and spend in one view, with participation reporting you can act on at renewal
Twin Health
Employer reporting not described publicly.

Financial model

Levels
Not published. Scoped to your population in consultation. No outcomes guarantee published.
Twin Health
Fees at risk against outcomes. Twin reports $8.0k in annualized savings per member with a high-cost medication.

Twin Health entries come from usa.twinhealth.com and its employer, member, provider and security pages, read September 2026. They describe what Twin publishes. Where they publish nothing we say "not published" rather than claim the product can't do it. Twin's outcome and savings figures are its own reporting of a 2025 Cleveland Clinic study and its employer materials. Levels figures come from our IRB-approved study at levels.com/pro/outcomes, which is observational, participant-funded and has no control arm. The cohort size sits next to every number. If a row is out of date, tell us and we'll fix it.

What it costs

Where the investment goes, and who carries the risk.

Neither company publishes employer pricing. What you can compare is the shape of the deal. Who it covers, what the fee rides on, and what each vendor's own numbers say about reach.

Levels · population benefit and GLP-1 companion

22–33%

of members who started GLP-1 eligible exited the indication at one year, in the 62,236-member IRB study.

  • One benefit for the whole population, with the GLP-1 companion program included for every member on medication, at whatever coverage level you set.
  • Works with the prescribers and PBM you already have. No second clinic, no medication decisions handed to a vendor.
  • Pricing is scoped to your population in consultation. The study is public before you ask.

Twin Health · virtual clinic

Not published

for the fee. Savings claims are company-reported.

  • Fees ride on clinical outcomes for the members who qualify and activate. Twin reports 19% of eligibles activating in year one.
  • $8.0k annualized savings per member with at least one high-cost medication, from Twin's own employer materials.
  • Pricing is negotiated per account against clinical outcomes. The definitions behind "savings" and "activation" are Twin's own.

The bill you already pay

Half of it stops early.

About half of members stop GLP-1 therapy within the first year, and most of the lost weight comes back. That's from the Peterson Health Technology Institute's December 2025 report and the STEP 1 trial extension, not from us. Careful prescribing changes who starts. Changing daily behavior changes who finishes, and what's left a year after the last dose. Levels supports those daily behavior changes alongside existing clinical care.

Being fair

Where Twin Health is the better call.

Three situations where Twin Health may be the better fit. We'd rather you hear it from us.

Type 2 diabetes remission is the whole brief.

Twin's clinic is built around one goal, reversing diagnosed type 2 diabetes, and reports 71% of members reaching an A1C below 6.5% without glucose-lowering medication. If that single outcome is the mandate, Twin has more years on it.

Year-one engagement is the scored metric.

Twin reports 88% of activated members stayed engaged for a full year, from its Cleveland Clinic study. If retention within an activated cohort is the figure your RFP scores, Twin has it published.

Validation has to be third-party.

Twin is a Validation Institute validated provider and its Cleveland Clinic study ran in NEJM Catalyst. Our study is IRB-approved and clinically reviewed, but not yet independently validated.

If one of those is you, take the Twin meeting. If you need one program for the whole population, with a GLP-1 companion program for members on therapy, talk with us.

Working alongside

You can run both. Many populations should.

Twin is scoped to members who clear a diagnosis. Levels is scoped to everyone. Nothing here asks you to cancel a clinical program. The open question is what the rest of your population gets, and what happens to GLP-1 members once they stop.

  1. 01

    Start with the members Twin doesn't cover

    Launch the Levels wellness benefit to all eligible members. Anyone enrolled in a clinical program stays exactly where they are.

  2. 02

    Wrap the GLP-1 members you already pay for

    Add the companion program alongside your PBM coverage, from first dose through discontinuation. Keep medication decisions with your existing clinicians.

  3. 03

    Read the participation report at renewal

    Eligibility, participation and spend in one view. Decide on your own numbers.

Questions we get

Four straight answers.

Is Levels a replacement for Twin Health?
Not one for one. Twin is a virtual clinic for members with a diagnosis. Levels is a population benefit that works with the prescribers you have. Many employers run Levels across the whole population and keep a clinical program for the members already enrolled in one.
Does Levels prescribe GLP-1s?
No. Your PBM and your members' clinicians handle prescribing and medication management. Levels provides a companion program alongside that care, with education, nutrition and movement support from first dose through discontinuation.
How does the evidence compare?
Ours is an IRB-approved longitudinal study of 62,236 consented members and 1.15 billion glucose readings over 3.5 years. Cohort sizes, methods and limitations are at levels.com/pro/outcomes. Twin's is a 2025 Cleveland Clinic study in NEJM Catalyst, which reached us through Twin's marketing. Read both. Ours is observational with no control arm, and we say so on the page.
What does Twin Health cost?
They don't publish it. Fees are at risk against outcomes and negotiated per account. Twin reports $8.0k in annualized savings per member with a high-cost medication, and 19% of eligibles activating in year one. Both are Twin's figures. Ask for the definitions behind them in writing.

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