Cardiometabolic conditions are one of the most expensive cost drivers in employer and health plan populations. Approximately 120 million U.S. adults have hypertension, yet fewer than 1 in 4 have it controlled.¹ Another 115 million have prediabetes, but only 2.5% participate in a structured prevention program.² Annual cardiovascular spend in the U.S. exceeds $400 billion and is projected to exceed $1 trillion by 2050.³

Employers and health plans know about the risk. The gap is what happens between visits, when members are expected to manage blood pressure, blood sugar, weight, nutrition, movement, sleep, and medication routines largely on their own. This is where costs escalate. Without continuous support, early cardiometabolic risk can build into emergency visits, hospitalizations, and chronic conditions that surface much later in claims when it's too late to reverse the risk.

Closing that gap requires a shift from episodic care to continuous, proactive support. Pulse was built for that model. This report presents claims-based evidence for its financial impact. A Validation Institute-certified analysis of 940 Pulse participants, matched against 940 controls, found $2,055 lower annual cardiometabolic-related costs per member and a 2.5x gross return on investment.⁴

What this report helps you analyze

Cardiometabolic investment has to be more than clinically compelling. It has to be measurable, defensible, and tied to claims impact. This study gives teams the evidence to evaluate Pulse through that lens. The report documents financial impact across a real employer population, independently validated by the Validation Institute, with savings analyzed across inpatient admissions, outpatient procedures, office visits, emergency department use, behavioral health, and lab spend.⁴

The report also explains the methodology behind the result, including propensity score matching and difference-in-differences analysis. That gives finance teams and actuarial reviewers a clear view into how savings were measured.

Key findings inside the report

• Why cardiometabolic costs continue to rise despite significant investment
• What makes continuous cardiometabolic support structurally different from episodic intervention
• Claims-based savings across inpatient, outpatient, office visit, emergency department, behavioral health, and lab categories⁴
• How the study was designed and validated, including propensity score matching, difference-in-differences analysis, and Validation Institute certification⁴
• The four evidence-based pillars of Pulse: movement, nutrition, clinical monitoring, and sleep.
• How outcomes-based pricing and a 1.5x ROI performance guarantee can change the financial risk calculus for employers and health plans⁴