OBJECTIVES: Estimate the financial savings associated with participation in a transitional case management (TCM) program offered by Optum.  Nurses managed cases via telephone and face-to-face interventions following member’s inpatient admission. The program was designed to improve care and help save money by better managing post-discharge care of the participants. METHODS: Propensity-score-weighted difference-in-difference multiple regression analyses were used to estimate savings in total healthcare expenditures associated with active engagement in the CAD program.  Factors associated with the program participation and savings were also found via logistic regression. The study included cohorts of 80,032 participants and 29,054 non-participants who qualified for the program between July 2011 and December 2012. Pre- and post-program engagement periods extended for up to 12 months before and after the dates members qualified for the program.  Regression models controlled for age, gender, and health conditions along with inferred demographic characteristics such as minority status, education, income, and the supply of healthcare services in members’ zip code of residence.   RESULTS: The regression-adjusted average cost trend was $231 lower per member per month for program participants. About 42.4% of the participants were managed in a way that their cost savings exceeded the costs of providing the program. Factors associated with engagement were not always associated with program savings.  For example, lower income and lower supply of healthcare service areas were associated with lower participation rates but higher saving. On the other hand, those with higher risk scores and in higher age group were more likely to engage and also more likely to be managed in a way that lead to savings as well. CONCLUSIONS: The TCM program helped to generate savings.  Analyses of participation and savings allowed program providers to understand the pockets of program success and streamline future efforts to improve the program.