A prospective, pre-post historical control design trial with a concurrent control group cost/satisfaction analysis with a retrospective clinical study was undertaken with adult, Scott and White Health Plan (SWHP) patients with chronic illnesses. From 2007 to 2010, a total of 7,411 ICC and 10,148 control patients participated. Variables were costs, return on investment (ROI), iterative Patient Health Questionnaire (PHQ)9 scores, and satisfaction.