Cost-Effectiveness of a Lifestyle and Behavioral Care Model Targeting Cardiometabolic Disease Progression

Chronic diseases drive healthcare costs, and employers seek scalable strategies to improve health outcomes and control expenses. Telehealth behavioral care shows promise for managing chronic conditions, but its long-term economic value in employer populations is still unclear. We assessed the cost-effectiveness and ROI of a behavioral care (LBC) model using a Markov model in a custom analytic tool. The model simulated disease progression, healthcare utilization, and QALYs over five years from the employer perspective. Transition probabilities, costs, and mortality risks were obtained from the InHealth program, national sources, and published literature. Employees in the behavioral care model were compared with a control group receiving usual care. Among 4461 employees aged 40, intervention participants had five-year costs of $41,431, versus $47,834 for controls, saving $6403 per member and $28.6 million overall. Treated members gained 4.7 QALYs compared to 4.6 in controls, equivalent to 36.5 extra days of full health. The program had a ROI of 6.53, showing significant cost savings. Telehealth behavioral care is a cost-effective way to improve health outcomes and provide financial benefits to employers. These results support incorporating behavioral care into value-based benefits and highlight potential long-term savings through prevention and management of lifestyle-related chronic diseases.