--- title: Measuring virtual care impact with closed claims from HealthVerity Marketplace description: "Virtual PT study shows what’s possible with HealthVerity Marketplace closed claims: measurable cost, utilization, and ROI for digital health." image: https://blog.healthverity.com/hubfs/ask-an-expert-blog-featured-alt-5.png --- Announcing HealthVerity Precision Event Alerts, a next-generation physician alerting solution. 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One of the clearest examples comes from a recent PTJ [publication](https://blog.healthverity.com/measuring-cost-savings-of-virtual-pt-with-healthverity-marketplace-closed-claims), co-authored by **Dr. Ian Livingstone Ph.D., MBA, Sr. Director of Data Insights and Analytics** at HealthVerity.1 The study evaluated virtual physical therapy (PT) using **closed claims accessed through [HealthVerity Marketplace](https://healthverity.com/marketplace/)**, comparing costs and utilization with traditional in-person PT.1 For the digital health space, this analysis demonstrates exactly the type of evidence that decision makers expect: payer-grade insights into total cost of care, utilization patterns, and return on investment. The aim here is not to retell the study, it’s to show how to **run this kind of analysis at scale** and why **identity resolution plus closed claims** is a reliable and repeatable framework that can be leveraged by digital health research teams. for digital health research. ## Why closed claims are the gold standard for digital health evidence Closed claims capture **all-cause activity across all care settings during enrollment**, enabling researchers to quantify real-world cost and service patterns over defined timeframes like 6 or 12 months and beyond. This level of completeness is why closed claims remain the foundation for evaluating the effectiveness and value of digital health interventions. > **“Closed claims are payer based and patient centric, providing complete visibility into healthcare activity during periods of enrollment. This allows researchers to distinguish with confidence between events that did and did not occur. In contrast, open claims are provider centric and do not capture care delivered outside the reporting network, leaving researchers uncertain as to whether care never happened or just simply wasn’t captured.”** > > *- Dr. Livingstone Ph.D., MBA,* Sr. Director of Data Insights and Analytics   By starting with closed claims from HealthVerity Marketplace, researchers can answer payer-critical questions: Are costs going down? Are patients using fewer services? Does virtual care deliver a measurable ROI? ## A repeatable use case structure for virtual care studies The [Omada research](https://blog.healthverity.com/measuring-cost-savings-of-virtual-pt-with-healthverity-marketplace-closed-claims) is a clear example of how the value of digital health programs can be assessed in the real world. The framework is straightforward: 1. Identify the digital cohort and a separate, clean in-person comparison group based on relevant characteristics 2. Confirm continuous coverage and follow-up windows 3. Compare post-index costs and utilization at different follow-up intervals 4. Report relevant cost variables and, when relevant, ROI and service subcategories Together, these steps provide a **repeatable framework** for demonstrating the real-world value of digital health programs with closed claims. ## Accurate cohorts through identity resolution Accurate evidence starts with accurate cohorts. Given that patients participating in digital programs are difficult to detect in structured claims data, it is **Identity Manager and the HVID** that play a critical role and make this research achievable in the first place. These technologies allow researchers to correctly isolate participants in a digital program and create mutually exclusive comparison groups, which strengthens the study design and validity of its findings. > **“Robust identity resolution is the foundation for establishing accurate patient cohorts. Too often, attention is placed only on the data itself without first validating that the underlying patients have been correctly identified. This can result in downstream analyses being misdirected and ultimately compromise the integrity of the study.”** > > *- Dr. Livingstone Ph.D., MBA,* Sr. Director of Data Insights and Analytics With the right patients identified, closed claims analysis can then provide the trusted cost and utilization evidence that payers require. ## How payers and employers use this real-world evidence Closed claims analyses like the Omada use case provide **comparable cost and utilization signals** that payers and employers can act on. Findings can inform **rate negotiations**, program **participation thresholds**, and where virtual physical therapy fits as a **first-line** option when clinically appropriate.   ### How payers and employers apply closed claims evidence: - Include virtual PT as a covered option when evidence shows lower cost and comparable outcomes expectations - Write performance benchmarks around **encounter reduction** and **MSK cost trends** - Structure contracts that reflect **participation** and **follow-up windows** at specified intervals > **“Properly identifying and linking digital health patients to closed claims enables reliable assessment of utilization and costs, providing the evidence needed to demonstrate value to payers and employers .”** > > *- Dr. Livingstone Ph.D., MBA,* Sr. Director of Data Insights and Analytics For decision makers, this kind of evidence shortens the distance between pilot programs and full coverage. ## Why this matters to digital health and pharma The Omada study is just one use case, but the model applies broadly. Whether it is MSK care, behavioral health, or other virtual programs, **closed claims accessed through [HealthVerity Marketplace](https://healthverity.com/marketplace/)** allow innovators to demonstrate measurable value to payers. Dr. Livingstone emphasizes that reliable cohorts and comprehensive closed claims are a backbone for digital health evaluations focusing on costs, utilization, and/or ROI. When paired with other real-world evidence like EHR and lab data, they open the door to even richer insights on outcomes, clinical characteristics, and quality of life. ## Explore closed claims in HealthVerity Marketplace For any digital health program looking to prove its value, [HealthVerity Marketplace](https://healthverity.com/marketplace/) offers the closed claims, scale, and enrollment visibility needed to generate payer-ready evidence. When combined with identity resolution, Marketplace enables clean cohorts, robust comparisons, and the kind of insights that shape benefit design and payer adoption. [![Ready to apply these insights? Connect with our team to explore data-driven solutions tailored to your goals. ](https://no-cache.hubspot.com/cta/default/5412465/interactive-192717537905.png)](https://blog.healthverity.com/hs/cta/wi/redirect?encryptedPayload=AVxigLIuPpXUIpXrK0QQ65MhEIP5pFtLCLzv92TfL7zWyL%2B3Xk%2Fc6Ldz8OITvq21CJTX2yNfZ2Vy6YQkpsM5cSxbO9tNBnTHt4k44ZeOGBg0g1chAWOvh%2FyHRV5g9rBgFWEzZe3y9RlvE6EYPQZLk9pSHIKQs2QQtiBwSWXGYRon3shT%2BtQqUPqYEzX5PHbtPsxcwDY9Pr0I%2Flk%3D&webInteractiveContentId=192717537905&portalId=5412465)   ## References 1. Napoleone JM, Devaraj SM, Noble M, et al. Health care cost savings and utilization reductions associated with virtual physical therapy care: a propensity-matched claims analysis. Phys Ther. 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