title: Leveraging remote behavioral health interventions to improve medical outcomes and reduce costs.
abstract: OBJECTIVE
  The dramatic rise in healthcare expenditures calls for innovative and scalable strategies to achieve measurable, near-term improvements in health. Our objective was to determine whether a remotely delivered behavioral health intervention could improve medical health, reduce hospital admissions, and lower cost of care for individuals with a recent cardiovascular event.
  
  
  METHODS
  This retrospective observational cohort study included members of a commercial health plan referred to participate in AbilTo’s Cardiac Health Program. AbilTo is a national provider of telehealth, behavioral change programs for high risk medical populations.
  
  
  METHODS
  The program is an 8-week behavioral health intervention delivered by a licensed clinical social worker and a behavioral coach via phone or secure video.
  
  
  RESULTS
  Among the 201 intervention and 180 comparison subjects, the study found that program participants had significantly fewer all-cause hospital admissions in 6 months (293 per 1000 persons/year vs 493 per 1000 persons/year in the comparison group) resulting in an adjusted percent reduction of 31% (P = .03), and significantly fewer total hospital days (1455 days per 1000 persons/year vs 3933 per 1000 persons/year) with an adjusted percent decline of 48% (P = .01). This resulted in an overall savings in the cost of care even after accounting for total program costs.
  
  
  CONCLUSIONS
  Successful patient engagement in a national, remotely delivered behavioral health intervention can reduce medical utilization in a targeted cardiac population. A restored focus on tackling barriers to behavior change in order to improve medical health is an effective, achievable population health strategy for reducing health costs in the United States.
authors.forename: Reena L
authors.initials: RL
authors.lastname: Pande
authors.forename: Michael
authors.initials: M
authors.lastname: Morris
authors.forename: Aimee
authors.initials: A
authors.lastname: Peters
authors.forename: Claire M
authors.initials: CM
authors.lastname: Spettell
authors.forename: Richard
authors.initials: R
authors.lastname: Feifer
authors.forename: William
authors.initials: W
authors.lastname: Gillis
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000191:economics / Q000379:methods*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D017046:Cost Savings; D005260:Female; D015438:Health Behavior; D005102:Health Expenditures; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010353:Patient Education as Topic / Q000191:economics / Q000379:methods; D015397:Program Evaluation; D012189:Retrospective Studies; D017216:Telemedicine / Q000191:economics / Q000379:methods*; D016896:Treatment Outcome; D014481:United States