OBJECTIVES: The 2013 American College of Cardiology/American Heart Association (ACC /AHA) guidelines may expand eligibility for cholesterol-lowering therapy to a large number of new users. The objective of this paper is to document the potential for this expansion in to improve clinical outcomes and reduce cost. METHODS: Patients meeting 2013 guideline classification criteria were identified using Humana data [2007-2013] and divided into three groups: elevated LDL [identified in earlier guidelines], selected diabetes patients and patients with atherosclerotic cardiovascular diseases [ASCVD]. Patients with no pre-classification cholesterol treatment were then selected and divided in two treatment groups: early [before any CVD event] and late/never treated. The clinical outcomes were the time to four separate events [AMI, stroke, coronary stenting, coronary artery bypass graft surgery (CABG)]. Costs were measured over the first year following a risk classification. Clinical outcomes were analyzed using Cox proportional hazards models. Costs were analyzed using generalized linear models [GLM] and the RAND two-step model for hospital costs. RESULTS: CONCLUSIONS: The 2013 treatment guidelines for cholesterol-lowering therapy will significantly increase the number of patients eligible for treatment. However, all eligible patients must receive ‘Early’ treatment to experience reduced CVD event risk and lower health care.