JMIR Publications

ABSTRACT

Background:

Mobile 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, a minority are grounded in evidence-based practice, while fewer have line of sight into population-level healthcare spend, limiting the clinical utility of such tools.

Objective:

To explore the influence of a health plan-sponsored, wearable-based, reward-driven, digital health intervention (DHI) on healthcare spend over one year.

Methods:

This study deployed a propensity score matched two-group, 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 month were allocated to the intervention group (N=56,816). Members who were eligible for the DHI, but did not enlist were propensity-matched to the comparison group (N=56,816). Average (and relative change from baseline) medical and pharmacy spend per user per month (PUPM) was computed for each member of the intervention and comparison group during the pre- (ie, 12 month) and post- enlistment (ie, 7-12 month) periods.

Results:

Compared to a propensity-matched cohort, DHI users demonstrated ~$10 PUPM lower average medical spend (P=.015) with a concomitant increase in preventive care activities and decrease in non- emergent emergency department admissions.

Conclusions:

This employer-sponsored, digital health engagement program has high likelihood for return on investment within one 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.