Evidence map›Paper›PMID 36917152›Full record

Observational studyJournal of medical Internet research2023

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

Amanda Zaleski, Brittany Sigler, Alan Leggitt, Shruti Choudhary, Ryan Berns, Kyu Rhee, Heidi Schwarzwald

Abstract readObservational Study
In one paragraph

Observational study in Journal of medical Internet research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Amanda Zaleski *Clinical Evidence Development, Aetna Medical Affairs, CVS Health, Hartford, CT, United States.ORCID 0000-0002-0362-819X
Brittany Sigler *Aetna Digital Product Development, CVS Health, Wellesley, MA, United States.ORCID 0000-0003-4892-0239
Alan LeggittAetna Analytics & Behavior Change, CVS Health, New York, NY, United States.ORCID 0000-0002-1431-0056
Shruti ChoudharyAetna Analytics & Behavior Change, CVS Health, New York, NY, United States.ORCID 0000-0003-1814-3491
Ryan BernsAetna Analytics & Behavior Change, CVS Health, New York, NY, United States.ORCID 0000-0001-8793-4380
Kyu RheeAetna Medical Affairs, CVS Health, Hartford, CT, United States.ORCID 0000-0002-1545-2232
Heidi SchwarzwaldAetna Medical Affairs, CVS Health, Hartford, CT, United States.ORCID 0000-0002-7748-1397

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMobile health (mHealth) technology holds great promise as an easily accessible and effective solution to improve population health at scale. Despite the abundance of mHealth offerings, only a minority are grounded in evidence-based practice, whereas even fewer have line of sight into population-level health care spending, limiting the clinical utility of such tools.

objectiveThis study aimed to explore the influence of a health plan-sponsored, wearable-based, and reward-driven digital health intervention (DHI) on health care spending over 1 year. The DHI was delivered through a smartphone-based mHealth app available only to members of a large commercial health plan and leveraged a combination of behavioral economics, user-generated sensor data from the connected wearable device, and claims history to create personalized, evidence-based recommendations for each user.

methodsThis study deployed a propensity score-matched, 2-group, and pre-post observational design. Adults (≥18 years of age) enrolled in a large, national commercial health plan and self-enlisted in the DHI for ≥7 months were allocated to the intervention group (n=56,816). Members who were eligible for the DHI but did not enlist were propensity score-matched to the comparison group (n=56,816). Average (and relative change from baseline) medical and pharmacy spending per user per month was computed for each member of the intervention and comparison groups during the pre- (ie, 12 months) and postenlistment (ie, 7-12 months) periods using claims data.

resultsBaseline characteristics and medical spending were similar between groups (P=.89). On average, the total included sample population (N=113,632) consisted of young to middle-age (mean age 38.81 years), mostly White (n=55,562, 48.90%), male (n=46,731, 41.12%) and female (n=66,482, 58.51%) participants. Compared to a propensity score-matched cohort, DHI users demonstrated approximately US $10 per user per month lower average medical spending (P=.02) with a concomitant increase in preventive care activities and decrease in nonemergent emergency department admissions. These savings translated to approximately US $6.8 million in avoidable health care costs over the course of 1 year.

conclusionsThis employer-sponsored, digital health engagement program has a high likelihood for return on investment within 1 year owing to clinically meaningful changes in health-seeking behaviors and downstream medical cost savings. Future research should aim to elucidate health behavior-related mechanisms in support of these findings and continue to explore novel strategies to ensure equitable access of DHIs to underserved populations that stand to benefit the most.

Indexed as

Drug CostsHealth Care CostsAdultCohort StudiesFemaleHumansInfantMaleMiddle AgedPropensity ScoreRetrospective Studiescost-effectivenessdigital health interventionhealth care costhealth planmedical costmobile appmobile health appphysical activitywearablewellness

Identifiers

PMID36917152
PMCPMC10131601

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.