Open Access Highly Accessed Research article

The impact of chronic disease self-management programs: healthcare savings through a community-based intervention

SangNam Ahn17*, Rashmita Basu2, Matthew Lee Smith37, Luohua Jiang4, Kate Lorig5, Nancy Whitelaw6 and Marcia G Ory7

Author Affiliations

1 School of Public Health, Division of Health Systems Management and Policy, The University of Memphis, Memphis, TN, USA

2 Scott & White Healthcare, Temple, TX, USA

3 Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, USA

4 Department of Epidemiology and Biostatistics, School of Rural Public Health, Texas A&M Health Science Center, College Station, TX, USA

5 Department of Medicine, Stanford University, Palo Alto, CA, USA

6 National Council on Aging, Washington, DC, USA

7 Department of Health Promotion and Community Health Sciences, School of Rural Public Health, Texas A&M Health Science Center, College Station, TX, USA

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BMC Public Health 2013, 13:1141  doi:10.1186/1471-2458-13-1141

Published: 6 December 2013



Among the most studied evidence-based programs, the Chronic Disease Self-Management Program (CDSMP) has been shown to help participants improve their health behaviors, health outcomes, and reduce healthcare utilization. However, there is a lack of information on how CDSMP, when nationally disseminated, impacts healthcare utilization and averts healthcare costs. The purposes of this study were to: 1) document reductions in healthcare utilization among national CDSMP participants; 2) calculate potential cost savings associated with emergency room (ER) visits and hospitalizations; and 3) extrapolate the cost savings estimation to the American adults.


The national study of CDSMP surveyed 1,170 community-dwelling CDSMP participants at baseline, 6 months, and 12 months from 22 organizations in 17 states. The procedure used to estimate potential cost savings included: 1) examining the pattern of healthcare utilization among CDSMP participants from self-reported healthcare utilization assessed at baseline, 6 months, and 12 months; 2) calculating age-adjusted average costs for persons using the 2010 Medical Expenditure Panel Survey; 3) calculating costs saved from reductions in healthcare utilization; 4) estimating per participant program costs; 5) computing potential cost savings by deducting program costs from estimated healthcare savings; and 6) extrapolating savings to national populations using Census data combined with national health statistics.


Findings from analyses showed significant reductions in ER visits (5%) at both the 6-month and 12-month assessments as well as hospitalizations (3%) at 6 months among national CDSMP participants. This equates to potential net savings of $364 per participant and a national savings of $3.3 billion if 5% of adults with one or more chronic conditions were reached.


Findings emphasize the value of public health tertiary prevention interventions and the need for policies to support widespread adoption of CDSMP.

Chronic disease self-management program; Healthcare utilization; Healthcare cost savings