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KPI & ROI Studies
Understanding outcomes: human-centered research demonstrating measurable impact and future value.
Evidence matters when access, recovery, and long-term health are the goal.
The ROI model should be interpreted as a scenario-based value proposition rather than a forecast of realized savings. Key outputs depend on program engagement, utilization-change assumptions, benchmark costs, and projected program fees.
Two Components
A diabetes total cost of care benchmark analysis and an illustrative ROI model applying utilization assumptions to fully engaged participants.
Clinical Evidence
Digital and home-based interventions show potential to improve sedentary time, glycemic measures, blood pressure, and cardiovascular risk factors.
Narrative Support
Digitally supported, multifactorial, and home-based programs can influence behaviors and intermediate clinical measures.
Total Cost of Care Benchmark & Value Proposition
Benchmark Analysis
Compares medical and pharmacy costs across diabetes cohorts using allowed cost, utilization per 1,000, unit cost, and PMPM by service category.
Cohort Comparison
Compare newly identified and consistently identified diabetes members. PMPM ratios and differences by major service category.
Value Proposition
Post-intervention PMPM, dollar impact, program fees, gross ROI, and net ROI for fully engaged participants.
Diabetes Total Cost of Care by Cohort
Key Utilization Drivers for the ROI Model
Illustrative Program Assumptions
Starting PMPM: $2,156. Post-intervention PMPM: $2,141. Program fees: $25,906. Illustrative interpretation only — not a forecast of realized savings.
Supporting Evidence Studies
Digital Health in Type 2 Diabetes
Improved HbA1c, fasting glucose, and postprandial glucose; no significant improvement in physical activity or HOMA-IR. The most directly relevant study for a diabetes value proposition. Supports a potential glycemic pathway.
Digital Health & Sedentary Behavior
Digital interventions reduced overall sitting time by 30.8 minutes relative to comparators.
Home-Based Exercise & Hypertension
Endurance, isometric strength, and breathing programs appeared effective in reducing blood pressure.
A1C Improvement & Acute-Care Utilization
0.9–1.1 point A1C reduction accompanied by lower diabetes-related hospitalizations (up to 52.7%) and ED visits (up to 36.6%). Strong utilization-plausibility evidence.
Telemonitoring & ED Visits
Greater A1C reduction, fewer ED visits, and reported healthcare savings over six months.
Glycemic Control & Acute-Care Costs
HbA1c <7% associated with lower annual acute-care costs and total medical costs.
The Evidence Base Will Continue to Grow
Utilization and savings assumptions should be validated using client-specific claims data or a program-specific outcomes evaluation.
Clearly separate evidence-supported findings from hypothetical assumptions in the workbook and in any client-facing presentation.
Present conservative, expected, and optimistic scenarios, with each tied to documented sources or clearly stated clinical rationale.
Use clinical judgment and, where available, program-specific data to support any assumed relationship between clinical improvement and financial impact.
