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Cost-effectiveness of telehealth with remote patient monitoring for postpartum hypertension
Abstract
OBJECTIVE: Evaluate cost-effectiveness of telehealth with remote monitoring for postpartum hypertensive disorders from the hospital's perspective. METHODS: A decision tree was developed using results from a non-randomized controlled trial comparing telehealth to standard outpatient blood pressure monitoring. At discharge, postpartum women with a hypertensive disorder received a Bluetooth tablet, blood pressure monitor, and scale to submit vitals daily for 6 weeks. Women were managed and treated with a standard protocol. We performed a cost-effectiveness analysis using data from the hospital, device manufacturer supplied charges, and utilities. A cost-effectiveness threshold was set at $100,000/quality-adjusted life years. One-way and two-way sensitivity analyses were performed to evaluate the robustness of our results compared to baseline assumptions. RESULTS: Telehealth monitoring significantly reduced postpartum readmissions, 3.7% (8/214) versus 0.5% (1/214), and resulted in higher quality-adjusted life years. Telehealth monitoring was cost-effective and cost-saving. Average cost of telehealth per patient was $309, and was cost-effective to a cost of $420 per patient. Telehealth monitoring remained cost-effective down to an admission cost of $10,999 compared to our baseline-estimate for the average admission cost of $14,401. Telehealth monitoring also remained cost-effective when the postpartum readmission rate was 3.0% or higher with standard monitoring. With a cost saving of $93 per patient and an estimated 333,253 pregnant women with hypertension in the US a year, telehealth could reduce health care costs in the US by approximately $31 million a year. CONCLUSIONS: This study demonstrates telehealth with remote blood pressure monitoring may be a cost-effective and cost-saving solution for management of postpartum hypertension.
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“While meticulous, this process is essential in RPM-HTN programs to facilitate successful home-based monitoring, aid patients in managing hypertension, administer antihypertensive medications, detect masked hypertension, and help avoid emergencies that could escalate to higher-acuity care.24–27”
Citations
Cites
Methods for the Economic Evaluation of Health Care Programmes
Drummond, M. E., Sculpher, M. J., Torrance, G. W., O’Brien, B. J., & Stoddart, G. L. (2005) · doi:10.1093/oso/9780198529446.001.0001 · Cited by 13,648
Methods for the economic evaluation of health care programmes
Wilson, S. (1987) · Journal of Epidemiology & Community Health · doi:10.1136/jech.41.4.355-a · Cited by 4,312
(2013) · doi:10.1097/01.aog.0000437382.03963.88 · Cited by 3,961
Sanders, G. D., Neumann, P. J., Basu, A., Brock, D. W., Feeny, D., Krahn, M., Kuntz, K. M., Meltzer, D. O., Owens, D. K., Prosser, L. A., et al. (2016) · JAMA · doi:10.1001/jama.2016.12195 · Cited by 3,069
US Valuation of the EQ-5D Health States
Shaw, J. W., Johnson, J. A., & Coons, S. J. (2005) · Medical Care · doi:10.1097/00005650-200503000-00003 · Cited by 1,282
ACOG Committee Opinion No. 736: Optimizing Postpartum Care
(2018) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000002633 · Cited by 1,090
A Meta-Analysis of Remote Monitoring of Heart Failure Patients
Klersy, C., SILVESTRI, A. D., Gabutti, G., Regoli, F. D., & Auricchio, A. (2009) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2009.08.017 · Cited by 381
A multi-state analysis of postpartum readmissions in the United States
Clapp, M. A., Little, S. E., Zheng, J., & Robinson, J. N. (2016) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2016.01.174 · Cited by 241
World Trade Organization (2005) · World Trade Report · doi:10.30875/8466f5ca-en · Cited by 229
Hirshberg, A., Downes, K. L., & Srinivas, S. K. (2018) · BMJ Quality & Safety · doi:10.1136/bmjqs-2018-007837 · Cited by 179
Research works printed but not linked: 1
- Hirshberg A, Bittle MD, VanDerTuyn M, et al. Rapid-cycle innovation testing of text-based monitoring for management of postpartum hypertension. J Clin Outcomes Manag. 2017;24(2).
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Sorted by citations
Lewey, J., Beckie, T. M., Brown, H. L., Brown, S. D., Garovic, V. D., Khan, S. S., Miller, E. C., Sharma, G., Mehta, L. S., & on behalf of the American Heart Association Cardiovascular Disease and Stroke in Women and Underrepresented Populations Committee of the Council on Clinical Cardiology; Council on Cardiopulmonary, C. C. (2024) · Circulation · doi:10.1161/cir.0000000000001212 · Cited by 229
“37–39 It is important to note that remote BP monitoring has been found to be feasible in racially diverse populations and reduces disparities in postpartum BP monitoring.”
BackgroundHypertension in Pregnancy and Postpartum: Current Standards and Opportunities to Improve Care
Countouris, M. E., Mahmoud, Z., Cohen, J. B., Crousillat, D. R., Hameed, A. B., Harrington, C. M., Hauspurg, A. K., Honigberg, M. C., Lewey, J., Lindley, K. J., et al. (2025) · Circulation · doi:10.1161/circulationaha.124.073302 · Cited by 146
“78,80 Recent studies have shown that brief HBPM combined with medication self-management and telehealth support leads to lower BP at 6 and 9 months compared with usual postpartum care and is associated with improved measures of cardiac structure and function.”
Postpartum Home Blood Pressure Monitoring
Steele, D. W., Adam, G. P., Saldanha, I. J., Kanaan, G., Zahradnik, M. L., Danilack, V. A., Stuebe, A. M., Peahl, A. F., Chen, K. K., & Balk, E. M. (2023) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000005270 · Cited by 65
Association of a Remote Blood Pressure Monitoring Program With Postpartum Adverse Outcomes
Hirshberg, A., Zhu, Y., Smith–McLallen, A., & Srinivas, S. K. (2023) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000005197 · Cited by 50
Arkerson, B. J., Finneran, M. M., Harris, S. R., Schnorr, J., McElwee, E. R., Demosthenes, L. D., & Sawyer, R. (2023) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000005327 · Cited by 48
Best Practices for Managing Postpartum Hypertension
Kumar, N. R., Hirshberg, A., & Srinivas, S. K. (2022) · Current Obstetrics and Gynecology Reports · doi:10.1007/s13669-022-00343-6 · Cited by 45
Palatnik, A., Mukhtarova, N., Hetzel, S., & Hoppe, K. K. (2022) · Pregnancy Hypertension · doi:10.1016/j.preghy.2022.11.009 · Cited by 37
Self-citationClinical Outcomes Associated With a Remote Postpartum Hypertension Monitoring Program
Lemon, L. S., Quinn, B., Binstock, A., Larkin, J. C., Simhan, H. N., & Hauspurg, A. K. (2024) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000005665 · Cited by 27
Remote blood pressure management for postpartum hypertension: a cost-effectiveness analysis
Mei, J. Y., Hauspurg, A. K., Corry-Saavedra, K., Nguyen, T., Murphy, A. M., & Miller, E. S. (2024) · American Journal of Obstetrics & Gynecology MFM · doi:10.1016/j.ajogmf.2024.101442 · Cited by 22
“A cost-effectiveness analysis performed by Niu et al 49 used internal data from a parent trial to evaluate the cost-effectiveness of telehealth with remote patient monitoring for postpartum HTN. Compared with “no telehealth,” telehealth was cost-effective and sensitive to the cost of the program, admission cost, and r…”
InfluentialChiaranai, C., Chularee, S., Saokaew, S., Tungpunkom, P., Umnuaypornlert, A., Chaomuang, N., Doommai, N., & Nimkuntod, P. (2023) · International Journal of Nursing Studies Advances · doi:10.1016/j.ijnsa.2023.100169 · Cited by 21
“Moreover, telehealth technologies can help reduce healthcare costs by minimizing the need for in-person visits, which can be expensive and time-consuming for patients (Ben-Assuli, 2022; Niu et al., 2022; Snoswell et al., 2020; Monaghesh and Hajizadeh, 2020).”
BackgroundOdebunmi, O. O., Hughes, T. D., Waters, A. R., Urick, B. Y., Herron, C., Wangen, M., Rohweder, C. L., Ferrari, R. M., Marciniak, M. W., Wheeler, S. B., et al. (2024) · Journal of Medical Internet Research · doi:10.2196/50205 · Cited by 21
“…by the federal government, insurance companies and regulators should consider ways to create and maintain reimbursement models and incentives that could increase the use of telehealth services, as these services may help contain costs and be more patient-centered and convenient to some [37,38].”
BackgroundCardiovascular Risk Factor Management After Hypertensive Disorders of Pregnancy
Lewey, J., Sheehan, M., Bello, N., & Levine, L. D. (2024) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000005672 · Cited by 15
“31,32 Limited evidence exists to guide the optimal BP treatment threshold after HDP.”
Rajkumar, T., Hennessy, A., & Makris, A. (2024) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.16059 · Cited by 17
Management of Postpartum Preeclampsia and Hypertensive Disorders (MOPP)
Rosenfeld, E. B., Sagaram, D., Lee, R., Sadural, E., Miller, R. C., Lin, R., Jenkins, D., Blackledge, K. T., Nikodijevic, I., Rizzo, A., et al. (2025) · JACC Advances · doi:10.1016/j.jacadv.2025.101617 · Cited by 18
Postpartum remote home blood pressure monitoring: the new frontier
Corlin, T., Raghuraman, N., Rampersad, R. M., & Sabol, B. (2023) · AJOG Global Reports · doi:10.1016/j.xagr.2023.100251 · Cited by 16
“Inpatient readmissions are expensive, costing as much as $14,401 in 1 model.(24)”
BackgroundInfluentialPerinatal Remote Blood Pressure Monitoring
Lewkowitz, A. K., & Hauspurg, A. K. (2024) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000005690 · Cited by 15
Nir, O., Gur, D., Galler, E., Axelrod, M., Farhi, A., Barkai, G., Weisz, B., Sivan, E., Tovi, S. M., & Tsur, A. (2023) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.15018 · Cited by 15
Postpartum blood pressure control and the rate of readmission
Gibson, K. S., Olson, D. N., Lindberg, W., Keane, G., Keogh, T., Ranzini, A. C., Alban, C., & Haddock, J. (2024) · American Journal of Obstetrics & Gynecology MFM · doi:10.1016/j.ajogmf.2024.101384 · Cited by 13
Future of Electronic Healthcare Management: Blockchain and Artificial Intelligence Integration
Verma, P., Rao, C. M., Chapalamadugu, P. K., Tiwari, R., & Upadhyay, S. (2024) · Blockchain technologies · doi:10.1007/978-981-97-1249-6_9 · Cited by 13
Palatnik, A., Hauspurg, A. K., Hoppe, K. K., Yee, L. M., Kulinski, J. P., Khan, S. S., Sabol, B., Yarrington, C., Freaney, P. M., & Parker, S. E. (2024) · American Journal of Perinatology · doi:10.1055/a-2416-5974 · Cited by 8
Self-citationLovgren, T. R., Yao, R., Connealy, B. D., Bonebrake, R. G., Satpathy, H. K., Patel, E. M., & Dahlke, J. D. (2025) · Pregnancy · doi:10.1002/pmf2.70005 · Cited by 7
Cellular-Enabled Remote Patient Monitoring for Pregnancies Complicated by Hypertension
Jones, R. D., Peng, C., Jones, C. D., Long, B., Helton, V., & Eswaran, H. (2024) · Cardiovascular Digital Health Journal · doi:10.1016/j.cvdhj.2024.03.001 · Cited by 7
Sada, K., Iwata, S., Inoue, Y., Tanaka, E., Nishida, K., Kawahito, Y., Abe, A., Kawakami, A., & Miyamae, T. (2025) · Modern Rheumatology · doi:10.1093/mr/roaf012 · Cited by 7
Dubrofsky, L., Gundy, S., Boesch, L., Poolman, K., Nerenberg, K. A., & Tobe, S. W. (2023) · CJC Open · doi:10.1016/j.cjco.2023.03.003 · Cited by 7
“Telemonitoring of blood pressure in the immediate postpartum period has been shown to be feasible and highly acceptable by patients, as well as cost-effective.(17,18) Beyond the initial postpartum period focused on blood pressure monitoring, ongoing postpartum counselling is important, including identification and edu…”
BackgroundLi, J., Zhou, Q., Wang, Y., Duan, L., Xu, G., Zhu, L., Zhou, L., Lan, P., Tang, L., & Yu, Y. (2023) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-023-05780-6 · Cited by 7
Gunn, R., Watkins, S. L., Boston, D., Rosales, A. G., Massimino, S., Navale, S. M., Fitzpatrick, S. L., Dickerson, J. F., Gold, R. B., Lee, G., et al. (2024) · JMIR Formative Research · doi:10.2196/55732 · Cited by 9
“Its use has also been associated with improved health outcomes, reduced emergency department visits and hospital admissions, and lower costs of care [14-16].”
BackgroundBurgess, A., Deannuntis, T., & Wheeling, J. (2024) · MCN The American Journal of Maternal/Child Nursing · doi:10.1097/nmc.0000000000001019 · Cited by 8
“Niu et al. (2022) completed a non-randomized controlled trial where they enrolled postpartum women with hypertensive disorders have also shown a reduction in readmission (Hirshberg et al., 2023).”
MethodA rapid review of telehealth in women with recent de novo hypertensive disease of pregnancy
Awoyemi, T., Teeri, S., Daniel, E., Ogunmola, I., Ebili, U., Olojakpoke, E., Guzman, R. C. B., Ezekwueme, F., & Nunes, D. (2024) · Journal of Clinical Hypertension · doi:10.1111/jch.14886 · Cited by 5
Socioeconomic, Demographic, and Clinical Factors Associated with Postpartum Readmission
Jeganathan, S., Solmonovich, R. L., Álvarez, A., Gulersen, M., Benn, K., Rochelson, B. L., & Blitz, M. J. (2024) · Journal of Women s Health · doi:10.1089/jwh.2024.0040 · Cited by 5
Berhie, S. H., Little, S. E., Shulkin, J., Seely, E. W., Nour, N. M., & Wilkins-Haug, L. E. (2023) · American Journal of Perinatology · doi:10.1055/s-0043-1764207 · Cited by 6
“24 We can take advantage of this momentum, and the framework already in place, to innovate and redesign care models for postpartum hypertension incorporating proven strategies that utilize virtual care.”
BackgroundZhang, D. “., Millet, L., Bellows, B. K., Lee, S. L., & Mann, D. (2025) · medRxiv · doi:10.1101/2025.01.29.25321334 · Cited by 5
Hypertensive Disorders of Pregnancy: Reaching the Rural Population After Delivery
FREIHA, M., Sosso, J. L., & Kattah, A. G. (2025) · Current Hypertension Reports · doi:10.1007/s11906-025-01340-9 · Cited by 4
“A cost-effectiveness analysis of the intervention found that there was potential savings of 31 million US dollars per year due to reductions in admissions and higher quality of life [52].”
Bennett, C., Lemon, L. S., Venkatakrishnan, K., Ghosh, S., Simhan, H. N., & Hauspurg, A. K. (2025) · American Journal of Obstetrics & Gynecology MFM · doi:10.1016/j.ajogmf.2025.101836 · Cited by 4
Fisher, C. R., Dukhovny, D., & Warren, J. B. (2025) · Journal of Perinatology · doi:10.1038/s41372-025-02334-w · Cited by 3
Telehealth Challenges in Nursing: A Narrative Review
Sharkiya, S. H. (2024) · INTERNATIONAL JOURNAL OF CLINICAL SCIENCE AND MEDICAL RESEARCH · doi:10.55677/ijcsmr/v4i8-01/2024 · Cited by 3
Predictive Modeling of Hypertension-Related Postpartum Readmission: Retrospective Cohort Analysis
Tao, J., Larson, R. G., Mintz, Y. D., Alagöz, O., & Hoppe, K. K. (2024) · JMIR AI · doi:10.2196/48588 · Cited by 2
“These costs were based on estimates derived from our previous research [17].”
MethodSelf-citationMary, M., Clifford, S., & Creanga, A. A. (2026) · Healthcare · doi:10.3390/healthcare14081102 · Cited by 3
“However, associated patient and health system costs to implement HBPM systems were documented via cost-minimization and economic analyses [23,24,30,34,42,69].”
Barriers to postpartum care and how to overcome them
Romano, A., & Berezowsky, A. (2026) · American Journal of Obstetrics & Gynecology MFM · doi:10.1016/j.ajogmf.2026.102007 · Cited by 2
Comparing users to nonusers of remote patient monitoring for postpartum hypertension
Kidd, J. M. J., Alku, D., Vertichio, R., Akerman, M. B., Prasannan, L., Mann, D. M., Testa, P. A., Chavez, M. R., & Heo, H. J. (2024) · American Journal of Obstetrics & Gynecology MFM · doi:10.1016/j.ajogmf.2024.101520 · Cited by 1
Liu, X., Li, M., Tao, Y., Han, L., Su, L., Wu, L., Pan, X., Zhang, M., Guo, F., & Ding, X. (2025) · Nanomedicine · doi:10.1080/17435889.2025.2592972 · Cited by 1
Advancements in Remote Health Monitoring Systems Technologies
Munawar, M., Singh, T. M., & Mohana, R. M. (2025) · IGI Global eBooks · doi:10.4018/979-8-3373-1022-0.ch014 · Cited by 2
A Circuit Design of a Sensor Amplifier for Improving Blood Pressure Measurement in Telehealth System
Panergo, M. C., Cruz, F. R. G., & Maaliw, R. R., III (2021) · IEEE Annual Information Technology, Electronics and Mobile Communication Conference (IEMCON) · doi:10.1109/iemcon53756.2021.9623070 · Cited by 2
Zhang, D. S., Millet, L., Bellows, B. K., Lee, S., & Mann, D. (2026) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x251403059
“25 24 – 27 Previous research has shown that intervention protocols triggering patient-provider interactions on an as-needed basis, rather than at a standardized frequency, were associated with lower costs and greater effectiveness.”
Bowen, A. E., Garbacz, S. A., Alaniz, K. M., Berry-Smith, M., Bolt, D. M., Denson, J. S., Kliems, H., Sinaise, M. R. K., Resnik, F., & Hoppe, K. K. (2025) · Contemporary Clinical Trials · doi:10.1016/j.cct.2025.108133
Self-citationAdella, G. A., Hoque, Z., & Khanam, R. (2025) · Systematic Reviews · doi:10.1186/s13643-025-03024-6
Pike, M., Han, J., Chen, L., Albright, C. M., & Shree, R. S. (2026) · PLoS ONE · doi:10.1371/journal.pone.0342836
“Emerging studies suggest that RPM programs are likely cost-effective, including for reducing PPA [19,20].”
Jovanov, K., Stairs, J., Cruickshank, A., & Nash, C. M. (2026) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/j.jogc.2026.103263
A qualitative study exploring postpartum patients’ experiences with remote blood pressure monitoring
Thatipelli, S., Pestka, D. L., Honeyfield, K., Hansen, S., Rizvi, R. F., Melton, G. B., & Sabol, B. (2026) · Pregnancy · doi:10.1002/pmf2.70281
Heilig, A. L., van den Hout, W. B., & van Marle, M. E. V. D. A. –. (2026) · PharmacoEconomics · doi:10.1007/s40273-026-01620-5
Amaliyah, Z., Sari, S. M., Hajarrani, Z. A., Purwadhi, P., & Widjaja, Y. R. (2026) · Indonesian Journal of Innovation Multidisipliner Research · doi:10.69693/ijim.v4i3.1869
Daneshmand, M., Dasari, H., Hales, L., Patel, N., Katat, A. A., Altit, G., Grandi, S. M., Nerenberg, K. A., Daskalopoulou, S. S., & Malhamé, I. (2026) · Journal of the American Heart Association · doi:10.1161/jaha.126.049749
Metadata
- Authors
- Niu, B., Mukhtarova, N., Alagoz, O., & Hoppe, K.
- Affiliations
- University of Wisconsin–Madison (US)
- School of Medicine and Public Health, University of Wisconsin
- Corresponding author
- Hoppe, Kara
- Venue
- The Journal of Maternal-Fetal & Neonatal Medicine
- Publisher
- Informa UK Limited
- Published
- 2021-09-01
- Volume
- 35
- Issue
- 25
- Pages
- 7555-7561
- ISSN
- 1476-4954 (ISSN-L)
- 1476-7058
- OpenAlex
- W3196406473
- Cited by
- 52
- References
- 16
- Citations by year
- 2026: 9 · 2025: 12 · 2024: 19 · 2023: 9 · 2022: 2 · 2021: 1
- FWCI
- 6.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Maternal-Fetal & Neonatal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- UnityPoint Health-Meriter Foundation
- University of Wisconsin Department of Obstetrics & Gynecology
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Keywords
- telemedicine, remote patient monitoring, postpartum hypertension, hypertensive disorders of pregnancy, cost-effectiveness, postpartum readmission, blood pressure monitoring, quality-adjusted life years, hospital costs
- MeSH terms
- Cost-Benefit Analysis, Female, Humans, Hypertension, Monitoring, Physiologic, Pregnancy, Telemedicine, Postpartum Period
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