Abstract Body (Do not enter title and authors here): Background: Remote patient monitoring (RPM) has emerged as a promising strategy to improve outcomes and reduce costs among high-risk chronic disease populations. However, real-world evaluations quantifying its economic impact in value-based care settings for hypertensive patients remain limited. Our objective was to quantify the economic impact of RPM by comparing total cost of care (TCOC) in the 12 months before and after RPM initiation among beneficiaries with hypertension and/or diabetes enrolled in a structured RPM program using a retrospective, within-patient pre–post cohort analysis.

Hypothesis: We hypothesize that among patients with hypertension and/or diabetes, enrollment in the RPM program will lead to a significant reduction in annual TCOC, driven by decreases in inpatient admissions and emergency department (ED) visits.

Methods: We identified 597 Medicare beneficiaries with a documented diagnosis of hypertension and/or diabetes who engaged in a RPM program for at least five months between January and October 2024. For each participant, we compared TCOC (all-payer claims) over the 12 months preceding RPM initiation versus the 12 months following initiation. Paired t-tests evaluated mean differences in annual TCOC. Multivariable linear regression was used to assess the contribution of specific utilization components (inpatient admissions, ED visits) to observed cost changes.

Results: Among 597 RPM participants, mean annual TCOC declined from $39,291 ± $1,752 pre-RPM to $27,255 ± $1,901 post-RPM representing an absolute reduction of $12,036 ± $1,885 per patient (30.6%, p<0.0001). Regression analysis identified inpatient admissions (+$3,235 per admission, p<0.001) and ED visits (+$1,164 per visit, p<0.001) as the primary drivers of total cost reduction. A complementary between-group comparison (RPM versus non-RPM matched controls) yielded consistent findings, reinforcing the within-patient results.

Conclusions: Engagement in a mixed hypertension/diabetes RPM program was associated with a statistically and clinically significant 30.6% reduction in annual TCOC, driven predominantly by fewer inpatient admissions and ED visits. For every $1 increase in baseline TCOC, there was an associated $0.48 in cost savings. These findings underscore RPM’s strategic value for cost containment in value-based care and support targeted deployment, particularly among high-risk, high-cost patients, to maximize shared-savings potential.