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Updated: Oct 10, 2025
A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Retrospective Analysis and Forecasted Economic Impact of a Virtual Cardiac Rehabilitation Program in a Third-Party
Arash Harzand1, Aaron C Weidman2, Kenneth R Rayl2
1Emory University School of Medicine, Atlanta, GA, United States.
Insights
Home-based virtual cardiac rehabilitation (CR) can significantly increase patient participation and reduce hospital readmissions, leading to substantial cost savings for healthcare systems. This approach offers a convenient and affordable alternative to traditional facility-based programs.
Area of Science:
- Cardiology
- Health Services Research
- Digital Health
Background:
- Cardiac rehabilitation (CR) is vital for coronary artery disease (CAD) patients but faces low participation due to cost and inconvenience.
- The COVID-19 pandemic has further highlighted the need for accessible CR solutions.
- Facility-based CR programs have limited reach, necessitating alternative delivery models.
Purpose of the Study:
- To forecast the clinical and economic benefits of a home-based, virtual CR program.
- To guide future implementation strategies for expanding CR access.
- To analyze CR utilization and costs within a third-party payer system.
Main Methods:
- Retrospective cohort study using insurance claims data from a Pennsylvania third-party payer.
- Identified CAD patients admitted between October 2016 and September 2018.
- Calculated CR enrollment rates, hospital readmissions, and associated costs within 12 months post-discharge.
Main Results:
- Only 37% of eligible patients enrolled in facility-based CR, costing $2,922 per participant.
- All-cause readmission rates were 24% for CR participants versus 31% for non-participants.
- Annual hospital readmission costs averaged $30,814 per patient; virtual CR could save $1-9 million annually.
Conclusions:
- Home-based virtual CR is forecasted to significantly increase CR participation.
- Reduced downstream healthcare utilization, particularly hospital readmissions, is expected.
- Virtual CR offers substantial cost savings in third-party payer systems by improving access and adherence.
Abstract:
Background: Participation in cardiac rehabilitation (CR) is recommended for all patients with coronary artery disease (CAD) following hospitalization for acute coronary syndrome or stenting. Yet, few patients participate due to the inconvenience and high cost of attending a facility-based program, factors which have been magnified during the ongoing COVID pandemic. Based on a retrospective analysis of CR utilization and cost in a third-party payer environment, we forecasted the potential clinical and economic benefits of delivering a home-based, virtual CR program, with the goal of guiding future implementation efforts to expand CR access. Methods: We performed a retrospective cohort study using insurance claims data from a large, third-party payer in the state of Pennsylvania. Primary diagnostic and procedural codes were used to identify patients admitted for CAD between October 1, 2016, and September 30, 2018. Rates of enrollment in facility-based CR, as well as all-cause and cardiovascular hospital readmission and associated costs, were calculated during the 12-months following discharge. Results: Only 37% of the 7,264 identified eligible insured patients enrolled in a facility-based CR program within 12 months, incurring a mean delivery cost of $2,922 per participating patient. The 12-month all-cause readmission rate among these patients was 24%, compared to 31% among patients who did not participate in CR. Furthermore, among those readmitted, CR patients were readmitted less frequently than non-CR patients within this time period. The average per-patient cost from hospital readmissions was $30,814 per annum. Based on these trends, we forecasted that adoption of virtual CR among patients who previously declined CR would result in an annual cost savings between $1 and $9 million in the third-party healthcare system from a combination of increased overall CR enrollment and fewer hospital readmissions among new HBCR participants. Conclusions: Among insured patients eligible for CR in a third-party payer environment, implementation of a home-based virtual CR program is forecasted to yield significant cost savings through a combination of increased CR participation and a consequent reduction in downstream healthcare utilization.
