The Influence of a Wearable-Based Reward Program on Health Care Costs: Retrospective, Propensity Score-Matched Cohort...

Area of Science:

• Digital Health Interventions
• Population Health Management
• Health Economics

Background:

• Mobile health (mHealth) offers scalable population health improvement but often lacks evidence-based practice and cost-effectiveness data.
• Few mHealth tools demonstrate clinical utility by linking to healthcare spending.
• Limited integration of evidence-based practice and cost-saving analysis hinders mHealth adoption.

Purpose of the Study:

• To evaluate the impact of a health plan-sponsored, wearable-based digital health intervention (DHI) on healthcare spending over one year.
• To assess the DHI's effectiveness using behavioral economics, sensor data, and claims history for personalized recommendations.
• To determine the DHI's influence on medical and pharmacy costs within a large commercial health plan membership.

Main Methods:

• A propensity score-matched, pre-post observational design was employed.
• The study included 113,632 adult members of a national commercial health plan, with 56,816 in the intervention group and 56,816 in the matched comparison group.
• Medical and pharmacy spending per user per month were analyzed over 12 months pre- and 7-12 months post-enrollment using claims data.

Main Results:

• The digital health intervention (DHI) group showed an average reduction of approximately $10 per user per month in medical spending compared to the control group (P=.02).
• DHI users exhibited increased preventive care activities and fewer non-emergent emergency department visits.
• The intervention led to an estimated $6.8 million in avoidable healthcare costs annually.

Conclusions:

• Employer-sponsored digital health engagement programs can yield a significant return on investment within one year.
• The DHI demonstrated clinically meaningful changes in health behaviors and reduced medical costs.
• Future research should explore mechanisms driving health behavior changes and ensure equitable DHI access for underserved populations.