Moving from traditional fee-for-service models to value-based billing is an under utilized approach in preventive musculoskeletal (MSK) health. Value based models emphasize delivering better health outcomes through improving the quality of interactions versus measuring the quantity of them. A scalable, personalized, and patient centric approach could tip the balance of providing better health outcomes and cost efficiency for all parties over the long term. Despite its potential, leveraging value based approaches to prevent MSK acuity events remains in its infancy.
Sticking With What We Know: MSK Acuity Care Costs versus Preventive Measures
One of the primary obstacles in showcasing the value of preventive MSK care is the inherent difficulty in measuring effectiveness of upstream interventions and direct impact over the long term. Unlike acute care interventions, which offer immediate and tangible results, and can be priced per intervention, preventive MSK strategies often require extended periods of time to yield measurable outcomes. This delay complicates the process of demonstrating their value, particularly in an industry still maturing in its approach to preventive care (McKinsey & Company, 2022).
Beyond Engagement: Measuring True Impact
In many cases, the default metric used today to evaluate preventive MSK interventions is engagement rates. A flag is that consistent engagement alone is not a sufficient measure of success. High engagement metrics can be misleading; for example, an individual might engage in regular physical activity but still experience worsening function if the activity is not appropriately tailored to their condition. In contrast, a single corrective exercise experience may result in an individual going down a path of healing and improved function with the ability to increase their function and volume of movement over time, and avoiding acuity care costs.
The true value of preventive MSK care should be assessed through the measurable impact on an individual's overall well-being and the associated reduction in MSK-related acuity costs. Effective measurability will compare outcomes for individuals with access to preventive solutions versus those without access to tools, focusing on how these interventions influence downstream acuity incidences (CDC, 2021).
Proven Methods of Value-Based Care
Organizations and payers that embrace a long-term VBC model stand to gain substantial cost savings, particularly when compared to the current paradigm that heavily relies on costly reactive medical services. Digital health companies like Wondr Health and AgeBold illustrate how a personalized and domain-specific solution can yield favorable outcomes in the prevention of high acuity events at the core of their models. These platforms have demonstrated that a deep understanding of individual health needs and avoiding one-size-fits-all solutions are crucial for effective preventive care. As the MSK industry matures, adopting tailored MSK approaches like Wondr (weight loss) and Bold (aging), will be the key to offering better MSK function and quality of life over the long term.
Networks and Payers Seeking Alternatives
I’ve made this point many times: healthcare networks and payers embedded in the 'wait and see' approach are on the hook for higher cost, late-stage interventions. Acuity care solutions such as Hinge, Kaia, and Sword have grown in popularity over the last 4 years and will continue to expand in the market because of the need to serve the growing number of people living in acute pain or dysfunction. While this trend will continue, organizations have an opportunity to reduce costs and improve care by implementing preventive solutions to manage MSK health before issues escalate (McKinsey & Company, 2022).
What is Holding Us Up?
The caveat today, is that the forward-thinking entities who recognize the limitations of current reactive models, are searching within an underserved market of solutions that can offer true MSK prevention. This presents a huge opportunity for MSK providers to evolve into value based models that focus on population and patient outcomes first and the monetary value of the outcomes over a longer period, resulting in improving population health over the long term.
Where To
I strongly believe that offering solutions before acuity care is necessary, and monitoring the quality of these earlier interventions has massive promise to improve musculoskeletal health. As this preventive market continues to mature, organizations that embrace value based models and invest in personalized, outcome-oriented approaches, stand to achieve substantial cost savings and enhanced MSK health over time. If you are part of an organization seeking better outcomes, reach out and join the discussion - we want to learn and collaborate with you!
References
CDC. (2021). Physical Activity and Health. Centers for Disease Control and Prevention. Retrieved from CDC.gov
Health Affairs. (2023). The Cost of Musculoskeletal Disorders: Insights and Solutions. Health Affairs Journal. Retrieved from HealthAffairs.org
Hinge Health. (2023). Preventive Musculoskeletal Care: The Future of Healthcare. Hinge Health Report. Retrieved from HingeHealth.com
McKinsey & Company. (2022). The Economic Impact of Preventive Healthcare. McKinsey Report. Retrieved from McKinsey.com
PHTI MSK Care Report. (2023). Current Trends and Cost Implications in MSK Care. PHTI Report. Retrieved from PHTI.org
About movr
movr is a digital MSK & movement health solution, working with leaders in digital health by integrating smart assessments and personalized exercise solutions into existing health & wellness platforms.
movr's research-backed approach has been validated through over half a million movement assessments and personalized exercise recommendations.
To learn more, visit our website or contact us.
Comments