MSK Savings: 5 Reasons Why Medical Doctors Are the Missing Piece

The MSK specialty generates over $380 billion each year, with employers responsible for absorbing many of those costs (Dieleman, 2020). Self-funded employers are especially at risk for financial losses at the hands of inappropriate MSK care, as an estimated 50 percent of employee populations suffer from one or more of these conditions (USBJI, 2023).

MSK point solutions have tried for years to take on this challenge with digital physical therapy offerings that are not led by physicians. But despite these efforts, many employers have yet to see meaningful change in their MSK spend. This is because 40 percent of back and joint pain conditions, and more than 50 percent of chronic MSK conditions, require a medical doctor for diagnosis and treatment. Providing convenient access to care teams led by physicians who specialize in non-operative musculoskeletal care—as opposed to orthopedic surgeons, spine neurosurgeons, physical therapists, or health coaches—is a critical piece of the savings puzzle.

Tallying up the savings of medical doctor-led MSK care

To put it simply, offering employees easy access to a physician-led care team is a straight shot to major savings. With a specialty doctor at the helm, MSK solutions not only improve employee satisfaction and productivity but also deliver impressive year-over-year savings that are virtually unattainable with other care models. Here’s how:

• Reduced surgery utilization. It’s no secret that inappropriate surgery is a problem. More than 50 percent of spine surgeries for low back pain (LBP) are unnecessary, with the average national cost of a single-level posterolateral lumbar fusion (a common LBP surgery) skyrocketing the MSK bill by an estimated $26,000 per employee (HBR, 2017; Vadim, 2015). The good news is that most employees who experience LBP do not need surgery and will improve with appropriate non-operative care. Only a small minority of LBP cases warrant going under the knife—but only a physician trained in non-operative MSK care is equipped to make this call and give employees the reassurance and guidance needed for next steps. With an estimated 26 percent of employees suffering from back pain, and 13 percent undergoing surgery in the traditional care model, navigating employees to physician-led non-operative care could potentially save a company with 1,000 employees more than $439,000 for low back pain alone (Naidu, 2022; NCHS, 2021).

• Reduced opioid utilization. An estimated 19 percent of medications used to treat low back pain (LBP) are opioids, with nearly 77 percent intended for long-term use (George, 2020). According to one study, the costs of medication alone for chronic LBP come close to $11,000 per person (Zgierska, 2017). The only way to eliminate opioids from the equation is to provide access to physician-led care teams who do not prescribe a single opioid medication. By providing holistic, non-opioid pain care for your employees, 8.1 percent of which suffer from severe and frequent LBP, employers can achieve meaningful pain reductions while slashing prescription drug costs by over $891,000.

• Fewer imaging scans. Imaging is a costly investment that often delivers little returns. According to one study, 76 percent of knee MRIs performed before clinical consultation did not help determine next steps for care (Mohammed, 2020). But like surgery, reducing unnecessary imaging requires that employees have access to the right kind of physician–one who understands when getting an X-ray or MRI is required versus a knee-jerk reaction. With approximately one in four adults suffering from knee pain and each knee MRI without contrast costing an average of $620, companies with 1,000 employees could save as much as $117,800 for knee pain alone with specialty physician-led care that reduces unnecessary imaging (Bunt, 2018; MDsave, 2024).
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• Fewer visits to the ER. Low back pain accounts for more than 4.3 million visits to the emergency department annually, many of them unnecessary and the result of lack of access to MSK specialists (Magel, 2022). With more than 1 in 4 employees experiencing low back pain, and approximately 1 in 4 seeking care from an emergency department, urgent care, or other walk-in facility at an average cost of $530 per visit plus approximately $150 for x-rays, the total bill of care can add up quickly (CDC 2013, Luckhaupt, 2019; Moore, 2020). Providing employees with convenient access to virtual MSK care can reduce ER visits by at least 90 percent, saving a company with 1,000 employees more than $39,000 annually for back pain alone. Once again, though, these savings depend upon employee access to medical doctors, as physicians are the only clinicians trained to help employees understand when a trip to the emergency room is unnecessary, or in a small percentage of cases, actually required.
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• Boosted productivity. High-value care doesn’t just lower healthcare costs—it also improves performance in the workplace. One claims analysis of employees with LBP found that each employee lost a median of 27 work days due to temporary total disability (Gaspar, 2021). Even when employees can come to work, they often struggle to perform at their standard level due to chronic pain, resulting in an estimated loss of 16.7 minutes per employee per day (Allen, 2018). All told, employers could save up to $1,685 per employee—or $1.69 million for a 1,000-employee company—by reducing LBP-related absenteeism and presenteeism (CDC, 2015).

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Unlock your multi-million dollar MSK savings

As a leading provider of physician-led, hybrid MSK care, Vori Health helps companies of all sizes save big on health benefits each year. With up to a four times return on investment and validated 77 percent improvement in pain scores, according to the Validation Institute, Vori Health is helping employers across the nation deliver appropriate, evidence evidence-based care to uncover new savings and provide long-term relief for employees.

Learn more about how medical-doctor led MSK care can drive unparalleled savings for your company.

REFERENCES

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