OBJECTIVES: Despite the availability of numerous therapeutic agents and management tools, half of all hypertensive patients do not have their blood pressure (BP) at goal.  A model was developed to estimate the incremental costs of uncontrolled vs. controlled hypertension and the impact of shifting patients to controlled status via a unique digital health feedback system. This Proteus system utilizes an Ingestible Sensor to determine medication-taking patterns, and a wearable 7-day sensor in the form of an adhesive patch to collect physiological and behavioral metrics such as heart rate, step count, and patterns of activity and rest, providing a means of determining non-response vs. non-adherence to prescribed medications and recommendations for daily routine. METHODS: The additional costs of outpatient services, monitoring, and cardiovascular complications were calculated for uncontrolled vs. controlled hypertensive patients from a US plan perspective for a 1 year time horizon. The clinical and utilization assumptions were derived from the literature and expert opinion, and costs were derived from the Medicare Fee Schedule and AHRQ databases.  The impact of the Proteus system on BP control was based on a real-world study evaluating this technology in 164 patients with a history of uncontrolled hypertension.    RESULTS: In a health plan of 1 million members, 7.9% (78,656) were uncontrolled hypertensive patients receiving care who were eligible for the Proteus system. The direct annual medical costs of uncontrolled hypertension were estimated to be $60.9 million over the costs for controlled disease.  The Proteus system was estimated to result in $7.3-18.3 million in savings ($328-$717 per BP at goal), and lead to a 3-9% reduction in the number of coronary artery disease and stroke events in one year. CONCLUSIONS: Even in the short-term, a digital health feedback system appears to provide an effective way to mitigate the substantial costs of uncontrolled hypertension.