Investment in telehealth is associated with cost savings for some WIC nutrition education and breastfeeding support services

Abstract

Objective: Estimate startup costs, ongoing service delivery cost savings, and payback period (time to recoup startup costs) of telehealth interventions in the Telehealth Intervention Strategies for Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) project. Design: A return on investment analysis compared pre/post changes in startup costs and ongoing cost savings for interventions that varied by state (1 group-randomized control trial, 4 quasi-experimental matched comparison designs, 1 prepost design). Setting: Local WIC agencies in 6 states (Georgia, Michigan, Wisconsin, North Carolina, South Carolina, and District of Columbia) between February 2022 and September 2023. Participants: Local WIC agencies (n = 31 intervention, n = 25 comparison). Intervention(s): Telehealth interventions varied by state, including enhanced video conferencing and virtual services via customized online platforms. Variables Measured: Startup and ongoing service delivery costs, and payback period. Analysis: Difference-in-difference comparison of costs and return on investment analysis. Results: Startup costs ranged from $147,659 for an existing solution to $1,547,592 for a state agency with many local clinics that received grant-in-aid. Ongoing cost savings in 4/6 (Georgia, Michigan, North Carolina, and District of Columbia) states had a payback period from 1 to 21 months, undiscounted, and < 1 month longer when future savings were discounted. Conclusions and Implications: Savings in ongoing service delivery costs and comparatively short payback period in 4 out of 6 states suggest that telehealth is financially viable for WIC agencies and could provide additional flexibilities and convenience, although a financing source was needed for the original investment in startup costs.