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FM Model Documentation
KPI & ROI Study
An evidence-driven analysis of the Fun & Moving digital health platform's impact on diabetes total cost of care, utilization reduction, and measurable ROI.
2.58x
Gross ROI
Fully engaged participants
1.58x
Net ROI
After program fees
$66,776
Annual Impact
Per 100 fully engaged
411
Engaged Members
50% of projected users
Model Overview
FM Platform ROI Model
Benchmark
Compares total cost of care across three member cohorts: newly diagnosed diabetes, consistent diabetes, and non-diabetes.
Financial Drivers
Estimates savings from ED reduction, inpatient admission reduction, and increased office visits for preventive care.
Value Proposition
Post-intervention PMPM, dollar impact, program fees, gross ROI, and net ROI for fully engaged participants.
Benchmark Results
Diabetes Total Cost of Care by Cohort
| Cohort | Total PMPM | Inpatient | Outpatient | Professional | Other | Pharmacy |
|---|---|---|---|---|---|---|
| New Diabetes | $2,054 | $568 | $544 | $419 | $33 | $489 |
| Consistent Diabetes | $2,181 | $313 | $505 | $390 | $45 | $927 |
| Non-Diabetes | $715 | $93 | $208 | $214 | $9 | $191 |
Value Proposition
Illustrative Program Assumptions
100,000
Covered Lives
Total eligible population in the plan
8.2%
Diabetes Prevalence
Industry-standard diabetes prevalence rate
8,224
Members w/ Diabetes
Diagnosed diabetic population
10%
Projected Users
Expected platform adoption rate
50%
Fully Engaged
Members completing core program
411
Engaged Members
Final cohort for ROI calculation
Illustrative ROI
Return on Investment
2.58x
Gross ROI
Total savings vs. program fees (gross)
1.58x
Net ROI
Net savings after program fees
$66,776
Annual Impact
Per 100 fully engaged participants
$42,140
Net Savings
After $24,636 program fees
Financial Drivers
Key Utilization Drivers for the ROI Model
| Driver | Utilization | Unit Cost | Annual Savings |
|---|---|---|---|
| Emergency Dept. | 301 / 1,000 | $2,422 | $60 |
| Inpatient Admissions | 68 / 1,000 | $28,427 | $161 |
| Office Visits | 4,431 / 1,000 | $138 | $51 |
Evidence Library
Supporting Evidence Studies
01
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.
02
Digital Health & Sedentary Behavior
Digital interventions reduced overall sitting time by 30.8 minutes relative to comparators.
03
Home-Based Exercise & Hypertension
Endurance, isometric strength, and breathing programs appeared effective in reducing blood pressure.
04
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.
05
Telemonitoring & ED Visits
Greater A1C reduction, fewer ED visits, and reported healthcare savings over six months.
06
Glycemic Control & Acute-Care Costs
HbA1c <7% associated with lower annual acute-care costs and total medical costs.
Limitations & Next Steps
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 conservative, expected, and optimistic scenarios with transparent assumptions and clear documentation of sources.
