OBJECTIVES: Heart failure (HF) is a critical health condition and places a substantial burden on patients and payers. Facilitating an earlier discharge from hospital would reduce hospital resource use only if patient safety can be maintained. The remote monitoring Heart Failure Management System (HFMS) has been shown to reduce HF-related readmissions. The impact of HFMS implementation on insurance payer budgets is assessed.

METHODS: A nine-state Markov model was developed in Excel to simulate post-discharge care with and without HFMS. Health states were: Outpatient, ER1, Readmission, Outpatient2, ER2, Subsequent readmission, Escalation of care, Post escalation of care, and Death. The model assessed a one-year outcomes from the insurance payer perspective in the USA. Costs in 2022 USD ($). Incidence and cost data were sourced from peer-reviewed literature via a systematic literature review. HFMS data were taken from the BMAD publication, were applied for 90 days only as incidences were assumed to be the same for both arms beyond this period, and no cost was applied to HFMS device. Outcomes considered were total costs of care per patient and cost per member per month.

RESULTS: Total one-year costs of care per patient were $44,060 with standard of care. With HFMS the cost of care was $37,597 ($6,463 lower). With a HF incidence of 2.65%, the cost per member per month was $1.43 lower with HFMS ($9.73 vs. $8.30). Cost reduction was driven by 0.14 fewer hospital readmissions per patient. Sensitivity analyses found per patient per year cost savings with HFMS to lie with a 95% credible interval of $3,418 and $10,866.

CONCLUSIONS: Implementation of HFMS is expected to result in cost savings for insurance payers due to fewer HF-related hospitalizations. Cost drivers are the length of readmission hospital stay and the cost per hospital day.