WHOOP's 12x health cost study rests on 80 people

A new WHOOP study says members with the lowest Strain and Sleep scores ran up about 12 times the health spending of everyone else. The study covers 80 people at one employer. Every author works for WHOOP.

The research letter ran in JMIR Formative Research on Oct 22 (doi:10.2196/109259). Its abstract says: “The lowest-attainment quartile incurred approximately 12-fold higher annual per-member health care spending than the other quartiles.”

The limits

80 people. The cohort is 80 adults on one US employer’s commercial health plan. All were WHOOP members with at least 45 days of data between Jun 1, 2024 and May 31, 2025. Each quartile holds 20 people.

Young and mostly male. Mean age was 34.2. Only 18 of the 80 were women. Age, sex, height and weight were self reported.

Associations only. The design is cross sectional, so it shows links and not causes. The authors write that they cannot rule out reverse causation, where illness both lowers the scores and raises costs.

WHOOP authors. All seven authors work for WHOOP, and WHOOP funded the study through their salaries. Their disclosure reads: “The authors are employees of WHOOP, Inc and hold stock options as part of employee compensation, representing a potential financial interest.”

The statement adds that WHOOP’s commercial groups had no role in approval, interpretation, writing or the decision to publish. The data are not public.

Claims in bulk. The employer sent only monthly medical and pharmacy totals for each quartile. The paper does not say what any claim paid for.

The authors call the findings “hypothesis generating” and say they “should not inform employment or insurance decisions.”

Where the 12x comes from

The authors scored members on how well they met WHOOP’s daily Strain recommendation and on their Sleep Performance. They averaged the two and split the cohort into four groups of 20.

The paper reports per member per year spending of $62,042 in the lowest quartile. The other three quartiles came in at $6,739, $3,091 and $5,656, a mean of $5,162.

That lowest group of 20 people accounted for 80% of the cohort’s $1.55 million in spending. Six catastrophic claim months made up 84.9% of its total.

Take out the single largest month, $307,311, and the lowest quartile drops to $46,676, about 9 times the rest. Take out all six months and it drops to $9,394, about 1.8 times.

What the wearable data showed

Each standard deviation higher on the composite score came with a resting heart rate 3.6 beats per minute lower (P=.001). It also came with a BMI 1.0 point lower (P=.005).

Heart rate variability was 9.1% higher per standard deviation. The 95% confidence interval ran from a 0.5% drop to a 19.5% gain, so it crosses zero.

The authors note that the Strain recommendation is calibrated to each member’s recent resting heart rate, heart rate variability and sleep. So those outcomes are not fully independent of the score.

What it means for Medicare

WHOOP is now in Medicare. CMS’s ACCESS Model tests paying for results in Original Medicare. It is voluntary, runs 10 years and began July 5, 2026.

The first tracks cover high blood pressure, diabetes, chronic musculoskeletal pain and depression. On Sep 15, CMS added heart failure, COPD, substance use disorder and nicotine tracks starting in spring 2027. It said 160 organizations joined at launch.

WHOOP Physician Services was picked for the first ACCESS cohort, WHOOP said on Apr 13. On Aug 12 it launched Connected Care in 14 states, with a nationwide rollout it said would finish within the month.

Connected Care gives eligible members a 12 month WHOOP membership and a blood pressure cuff at no out of pocket cost. Members need Original Medicare and at least one qualifying heart, kidney or metabolic condition. CMS says Medicare Advantage enrollees are not eligible for ACCESS.

None of the 80 people in the JMIR study were on Medicare. They were working adults with a mean age of 34.2 on a commercial plan. The paper offers no spending data on older adults or on the conditions ACCESS pays for.

WHOOP’s Aug 12 release cites its own figures for members 65 and older. It says 91% of monthly users open the app daily. It says more than half of those with elevated blood pressure or hypertension saw meaningful drops in systolic pressure within six months.

WHOOP cites internal analysis for both figures and has not published the underlying data.

We have covered ACCESS before, including Google Health’s Medicare data deals, Baba’s $40M round and Oura’s Cardio Effort. WHOOP is also running research studies with Abu Dhabi’s health regulator.