An analysis from the Regenstrief Institute found that Health First Indiana (HFI), the state’s landmark public health funding initiative, generated an estimated $742.6 million in direct and indirect cost savings through five key public health service areas during its first two years.
The evaluation assessed services delivered between January 2024 and December 2025 across cardiovascular screenings, diabetes prevention and treatment, obesity prevention and treatment, food security initiatives and prenatal care. Researchers found that these services alone produced approximately $229.3 million in direct healthcare savings and $513.2 million in indirect savings from reduced premature mortality and caregiving costs.
“Public health programs are often evaluated based on their costs, but this analysis demonstrates the substantial value they generate for communities, healthcare systems and taxpayers,” said Brian E. Dixon, PhD, MPA, director of the Public and Population Health Informatics Program at the Regenstrief Institute and co-lead of the study. “Our findings show that strategic investments in prevention can improve health outcomes while reducing future healthcare expenditures.”
Health First Indiana was established in 2023 and provided $225 million in biennial funding to Indiana’s local health departments. The initiative represented an increase in public health funding and expanded services across 16 core public health areas, and this evaluation included data from participating counties across Indiana
Researchers analyzed 437,455 services delivered by local health departments, representing approximately 10 percent of the more than 4.3 million services reported statewide under HFI. Because the analysis focused only five service categories, researchers note that the findings likely represent a conservative estimate of the program’s total economic impact.
Among the findings:
- Cardiovascular screenings identified an estimated 14,272 Hoosiers with previously undiagnosed hypertension and 6,844 individuals with previously undiagnosed high cholesterol, generating an estimated $518.7 million in lifetime savings.
- Diabetes prevention and treatment activities are expected to save approximately $26.2 million in healthcare costs through earlier identification, prevention programs and self-management education.
- Obesity prevention and treatment programs serving more than 60,000 Hoosiers are projected to generate approximately $111.7 million in reduced medical expenditures.
- Food security initiatives provided services to nearly 75,000 individuals and families, resulting in an estimated $14 million in savings.
- Prenatal care services generated an estimated $72 million in direct and indirect savings through improved maternal and infant health outcomes.
“Prevention remains one of the most effective tools available to improve population health and reduce long-term healthcare costs,” said Shaun J. Grannis, M.D., M.S., Regenstrief Institute vice president for data and analytics and co-lead of the study. “This evaluation provides evidence that public health infrastructure investments can produce measurable returns while helping Hoosiers live healthier lives.”
The report also identified opportunities to further strengthen public health impact through enhanced data reporting, stronger connections between community services and clinical care, and continued efforts to identify individuals living with undiagnosed conditions such as hypertension and diabetes.
The evaluation was conducted by researchers from Regenstrief Institute and the Center for Health Policy at the Fairbanks School of Public Health at Indiana University Indianapolis. The project used service data from Indiana Department of Health, clinical data from the Indiana Health Information Exchange, and evidence from peer-reviewed public health research. The analysis reflects Regenstrief’s mission to generate evidence that informs policy, strengthens healthcare delivery and improves health outcomes.
Read the full report here
Brian E. Dixon, PhD, MPA
In addition to his role as the director of public health informatics at the Regenstrief Institute and Indiana University Richard M. Fairbanks School of Public Health at Indiana University, Brian E. Dixon, PhD, MPA, is the interim director and a research scientist with the Clem McDonald Center for Biomedical Informatics at Regenstrief Institute and a professor of epidemiology at the Fairbanks School of Public Health. He is also an affiliate scientist at the U.S. Department of Veterans Affairs Health Systems Research and Development Center for Health Information and Communication, Richard L. Roudebush VA Medical Center.
Shaun Grannis, M.D., M.S.
In addition to his role as vice president for data and analytics and research scientist with the Clem McDonald Center for Biomedical Informatics, at Regenstrief Institute, Shaun Grannis, M.D., M.S., is the Regenstrief Professor of Medical Informatics and a professor of family medicine at Indiana University School of Medicine. He is also an adjunct professor with the Indiana University Richard M. Fairbanks School of Public Health at IU Indianapolis and at the Indiana University School of Informatics and Computing at IU Indianapolis.
