Related Experiment Video
Updated: Mar 12, 2026

A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Cost-Effectiveness of the Support and Services at Home (SASH) Program for Cardiovascular Risk Factors: A
Adam Atherly1, Casey Doerner2, Rong Yan1
1Department of Health Administration, College of Health Professions, Virginia Commonwealth University, Richmond, Virginia, USA.
Objective:
To estimate the cost effectiveness of the Support and Services at Home (SASH) program for health improvements associated with cardiovascular risk factors. Located in affordable housing units, SASH uses wellness approaches to prevent illness, manage chronic conditions and coordinate care delivery by connecting older adults and individuals with disabilities with community-based services.
Study Setting And Design:
We calculated total quality-adjusted life years (QALYs) gained from cardiovascular risk reduction and program costs using a Markov model.
Data Sources And Analytic Sample:
Data on changes in health status, health outcomes, and programmatic costs were drawn from SASH (primary) data sources from the statewide enrolled population in the original (Vermont) program. Data were collected from 2017 to 2023.
Principal Findings:
SASH reduced total cardiovascular risk factors including increases in appropriate medication use and reductions in systolic blood pressure. The cost per QALY gained ranged from $8344 to $4013 depending on gender and diabetes.
Conclusions:
SASH is a cost-effective approach to improving the health of older adults and individuals with disabilities through a housing-based community partnership. SASH is emblematic of the "wrong pocket" problem, so replication and funding of the model are challenging. For greater system efficiency and equity, finding ways to incorporate programs outside the healthcare system will be required.
Related Concept Videos
Atherosclerosis III: Management
Heart Failure VI: Adjunct Therapies
Acute Coronary Syndrome IV: Interprofessional Care
Coronary Artery Disease IV: Preventive Measures
Coronary Artery Disease V: Interprofessional Care
Heart Failure V: Medical Management

