Introduction: Hypoplastic left heart syndrome (HLHS) is a congenital heart defect often managed with three stages of palliative surgery. Interstage home monitoring programs (HMP) have recently been implemented to reduce the mortality between the first two stages. The cost-effectiveness of these programs has not been studied. Analysis of lifelong costs and outcomes with introduction of home monitoring may inform clinical decisions and reimbursement policies. Hypothesis: The HMP is a cost-effective method for detection of symptoms during the interstage period. Methods: A computational model was designed to simulate the lifetime progression of a patient with a single ventricle lesion undergoing three palliative surgeries. The focus of comparison is the interstage period, during which the two cohorts (home monitoring vs. no home monitoring) differ in cost, clinical outcomes, and quality of life. Our model was instantiated with data from studies relevant to the single ventricle population found in PubMed and Google Scholar literature searches. Clinical outcomes, cost, and quality of life data were derived from the most recent literature available to best represent current surgical methods, quality of care, and cost inflation factors. Clinical and cost data between stage I and stage II was carefully selected to ensure that outcomes were reported separately for patients with and without the HMP. We analyzed total hospital costs, rather than charges to insurance or patient out-of-pocket payments. Results: The home monitoring program was determined to be a cost-effective addition to the treatment pathway for HLHS, with an incremental cost-effectiveness ratio (ICER) of $54,064 per quality-adjusted life year (QALY) gained, and a 1.4-year increase in life expectancy. Conclusion: Home monitoring after stage I palliative surgery is a cost-effective addition to the treatment of HLHS when compared to a willingness-to-pay threshold of $100,000/QALY and to the ICERs of other well-accepted interventions. Further analysis should be pursued to account for limitations of this study and assess the cost-effectiveness of home monitoring in various scenarios. [ABSTRACT FROM AUTHOR]