Leveraging remote behavioral health interventions to improve medical outcomes and reduce costs

Am J Manag Care. 2015 Feb;21(2):e141-51.


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.

Study design: 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.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adult
  • Behavior Therapy / economics
  • Behavior Therapy / methods*
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / psychology
  • Cardiovascular Diseases / therapy*
  • Cost Savings*
  • Female
  • Health Behavior
  • Health Expenditures
  • Hospitalization / economics
  • Hospitalization / statistics & numerical data*
  • Humans
  • Life Style
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Patient Education as Topic / economics
  • Patient Education as Topic / methods
  • Program Evaluation
  • Retrospective Studies
  • Telemedicine / economics
  • Telemedicine / methods*
  • Treatment Outcome
  • United States