A uniform E5 deployment across clinicians, frontline staff, and administrators looked tidy on a spreadsheet and expensive in reality. The practice mapped licensing to how each population actually worked and removed $9.4M from the renewal. This is how a one size estate was rebuilt around real roles.
A multi hospital health system with roughly 42,000 Microsoft identities spanning physicians, nurses, frontline and shift based staff, and corporate administration. A prior security initiative had standardized the entire workforce on M365 E5, and the upcoming renewal carried that uniform footprint forward at full count, regardless of how differently each population used it.
The health system had standardized on E5 during a security and compliance program, for sound reasons at the time. The premium security, identity, and compliance capabilities mattered for a population handling protected health data. But the decision to deploy E5 universally hardened into a default, and the renewal simply assumed it would continue. Every identity in the directory carried the full premium entitlement whether or not the role ever touched the capabilities it paid for.
The workforce was anything but uniform. A large frontline and shift based population, including nursing assistants, facilities, and clinical support staff, used shared devices for narrow tasks and never opened the desktop applications, advanced analytics, or premium compliance features the E5 premium funds. Corporate administrators used a different slice. Physicians used another. A single license tier had been stretched across populations whose actual needs barely overlapped.
The renewal team had no usage evidence to challenge the footprint, only the prior count. Standardizing on the top tier is a security posture for some roles and pure waste for others, and only usage data can tell you which is which.
The engagement reconstructed M365 service level usage across the identity base, segmenting the workforce by genuine work pattern rather than by org chart. Active use of premium security, compliance, analytics, and desktop applications was measured for each population. The data drew a clear line between roles that genuinely consumed the E5 premium and roles that touched almost none of it, which is the line the uniform deployment had erased.
Licensing was then rebuilt around the segments. Clinicians and administrators handling sensitive data and using the full toolset stayed on E5 where the premium was genuinely earned. A large frontline and shift based population moved to F3, which fits shared device, narrow task work at a fraction of the cost while preserving the security baseline those roles require. A middle population stepped to E3 where the E5 premium capabilities went unused but full desktop applications were still needed.
The practice also protected the security posture through the change, confirming that the compliance and identity controls the health system relied on were preserved across every tier rather than weakened by the savings. Right sizing a healthcare estate only counts if the protection survives the optimization intact.
The renewal closed with the E5 footprint reduced by 61 percent, roughly 11,500 frontline identities moved to F3, and a further population stepped to E3, removing $9.4M from the agreement inside nine weeks. Every clinical and administrative role that genuinely used the premium capabilities retained them, and the security and compliance baseline the health system depended on was preserved across all tiers.
The system also kept a usage baseline it now refreshes rather than rebuilds. Future joiners are provisioned to the tier their role actually needs rather than the universal default, which keeps the estate aligned to real work between renewals instead of drifting back toward one size for everyone.
The engagement reflects the firm’s broader record across Microsoft contracts: more than $420M in cumulative client savings, over 340 engagements delivered, and an average 79 percent reduction in audit financial exposure, built on 20+ years of combined practice depth across the Microsoft estate. The figures above are verifiable on a reference call arranged through the practice.
The practice helps healthcare CIOs map M365 licensing to how clinical, frontline, and administrative populations actually work, removing waste without weakening the security posture. Two analyst calls, no pitch, and an honest read on the footprint.