Background:
Livongo’s Applied Health Signals Home Blood Pressure Monitoring Program (HBMP) offers patients a Bluetooth connected blood pressure cuff, hypertension (HTN) management education, and access to health coaches. Previous studies have demonstrated the clinical benefits of HBPM so the objective of this study was to also evaluate the impact on U.S. medical spending within the first year.
Methods:
People younger than 65 years with continuous enrollment in health benefits for the 12 months before and 12 months after launch of the HBMP and use of the program for at least three months were selected. Medical spending for those participants was compared to eligible but non-HBMP participant controls who were identified utilizing propensity score with nearest-neighbor matching methodology on age, gender, and pre-period medical spending with exact matching on Charlson Comorbidity Score Index in a 1:1 ratio. People with medical spending exceeding $50,000 monthly or $100,000 annually were excluded from the analysis. The HBPM participant baseline blood pressures were compared to BP values at 12-months to assess improvement in BP management. Mean medical spending based on the total allowed amounts per member per month (PMPM) was compared between the HBPM and non-HBPM groups using intention-to-treat difference-in-difference (DiD) analysis.
Results:
There were 1,417 HBPM participants with mean age of 51 years, 52% female, 64% with uncontrolled HTN (BP > = 130/80) at baseline, and mean pre-period medical spending of $490 PMPM. For participants with uncontrolled HTN, mean systolic and diastolic BP reductions were 14.2 mmHg and 10.1 mmHg, respectively, with 54% decreasing in HTN stage or considered controlled. The HBPM group had a 1% reduction in medical spending to $474 PMPM while the non-HBPM group had an 18% increase in medical spending from $410 PMPM to $486 PMPM resulting in a medical savings of $81 PMPM. The HBPM group also had a reduction of 33% in inpatient utilization and 14% in ED visits.
Conclusion:
HBPM participants experienced improved BP control and a reduction in total medical cost savings resulting in a positive return on investment. The main drivers of medical savings were a reduction in ED and inpatient hospital utilization.
Incorrect Label for Sex in Table in: Effectiveness of Home Blood Pressure Monitoring, Web Communication, and Pharmacist Care on Hypertension Control: A Randomized Controlled Trial
