OBJECTIVES: This study evaluated the impact of a mobile health (mHealth) cardiovascular disease (CVD) self-management program on medical spending, health care utilization, and clinical outcomes. METHODS: We conducted a retrospective cohort, pre-post observational analysis of medical claims data from February 2018 to September 2023. Participants enrolled in the mHealth CVD self-management program were compared to matched non-participants to assess changes in medical spending and utilization, employing a difference-in-differences (DiD) approach. Moderation analyses tested whether the effect of participation on medical costs differed according to participants' demographic and employer characteristics. Linear mixed models were also used to evaluate changes in participant blood pressure. RESULTS: There were 7,112 participants and an equal number of matched non-participants from 14 employers included in the cost savings analysis. Participation in the mHealth CVD self-management program was associated with an annualized per member savings of ,709 as compared to matched non-participants. While savings were consistent across participant sex and employer type, older participants experienced greater savings. Program participation was associated with fewer inpatient hospital days and increased primary care utilization following enrollment. Program participants experienced significant reductions in blood pressure, with the largest reductions seen among those with stage 2 hypertension at baseline. CONCLUSIONS: Participation in a mHealth CVD self-management program was associated with significant cost savings and clinical improvements across diverse populations, highlighting its effectiveness as a cost-efficient tool for managing CVD and improving health outcomes. Further research is needed to explore the long-term benefits and cost-effectiveness of mHealth programs to support broader adoption.