OBJECTIVES: Heart failure (HF) is a costly disease imposing a substantial health burden which affects 1-2% of Europeans. Hospital readmission for HF is a common occurrence with 25% of all patients readmitted within 30-days following initial hospitalization. Reducing readmission is an important component of managing HF costs and increasingly being targeted with healthcare policy reforms.    The objective of this study is to examine how remote patient monitoring (RPM) may affect healthcare costs following the placement of a CRT-D device for patients with HF through the use of a simulation model. METHODS: The analysis was an individual patient event-based simulation from a US payer perspective based on a sample of patients from RAPID-RF, a multi-center prospective single-arm registry which enrolled 889 patients who received a CRT-D and RPM system (LATITUDE® Boston Scientific).  The modeled population consisted of patients that had at least one alert for weight change, atrial tachycardia or ICD shock with a subsequent intervention (N=128).  The population was limited to this subset to focus on the costs of changes in management due to RPM.  A non-RPM control group was created by cloning each trial patient and simulating their response in the absence of RPM to the conditions that triggered each alert in the trial over one year using a decision tree which computed rates of hospitalization and physician contacts based on literature data. Event and hospitalization costs were estimated per Medicare (CMS) national average payment. RESULTS: RPM reduced total costs after the index procedure by $323/patient driven by a reduction in costs related to hospitalization admissions.  The decrease in hospital admission cost was partially offset by RPM’s increase in physician visits and telephone counseling. CONCLUSIONS: RPM has the potential to shift HF-related care from an inpatient setting to office-based care, resulting in cost savings to national payers.