Understanding how musculoskeletal conditions impact your workforce and which stage you should focus on to drive the greatest ROI.
Bruce, an IT Specialist at Walgreens was carrying a heavy box upstairs when he first felt a surge of pain in his knee. Over the years Bruce’s knee pain continued to flare up until it reached the point that he couldn’t leave the house. Bruce was plastered to his sofa, in tears, and desperate for an option to resolve his pain when he started considering a $35,000 surgery. With 1 in 6 health care dollars being consumed by musculoskeletal (MSK) spend, employers need to understand how MSK impacts their workforce so they can prioritize solutions that reduce pain, avoid surgery, and drive the greatest ROI. Evaluating solutions for members in the chronic stage will have the best ROI and will help your employees that are in pain, missing work, and on their way to scheduling an expensive surgery.
Understanding the MSK Journey
To understand why the chronic stage is the best population to focus your musculoskeletal strategy on let’s look at Bruce, whose journey is familiar to hundreds in any given workforce.
1. At risk members are hard to engage
Bruce has been overweight and not very physically active for a good part of his adult life. In his 20s and 30s, Bruce had risk factors for a musculoskeletal condition. However, it is difficult to engage employees who are at risk for MSK-related pain due to their weight, their work, or activities because they do not feel any direct pain. Bruce had tried for years to lose weight and to be more active, but he barely had enough time for himself between work and caring for his kids so had little intrinsic motivation.
2. Acute pain doesn’t last long
After Bruce’s initial accident walking up stairs he laid off his knee and rested and within a few weeks, the pain improved. Focusing on solutions for acute injuries such as prescriptions for pain management or physical therapy is not an effective solution because regardless of intervention 90% of acute pain will self-resolve within 6 weeks. In Bruce’s case, his initial knee injury subsided after a few weeks.
3. Surgery is not a guaranteed path to pain relief
In recent years, Bruce’s pain was so bad an expensive knee surgery looked to be the only option. Employers often try to support this decision making and steer members to the most cost effective options but surgery still isn’t a guaranteed path to pain relief. In fact, 20-40% of back surgeries fail. The only way to successfully steer employees away from surgery is by providing a credible alternative to address pain.
Why chronic MSK care drives the greatest ROI
Unlike other members, people with chronic pain are motivated because they are in pain, often daily, and will try anything that will reduce that pain. People with chronic conditions are the most frequent users of healthcare in the U.S. They account for 81% of hospital admissions; 91% of all prescriptions filled; and 76% of all physician visits. Interestingly, people with chronic pain do not need clinical interventions, they need behavioral intervention. Clinical studies show that for long-term outcomes, the best way to address chronic MSK pain is with the three pillars of best practice care: exercise therapy, behavioral health, and education. By providing members with a credible alternative to surgery, 2 out of 3 surgeries are avoided which accounts for a 3-6x ROI in year-1.
Bruce was a Hinge Health participant this past year. Like many people with chronic pain, getting moving wasn’t easy. He credits the support of health coaches and education to help him meet his exercise therapy goals each week. Since completing the program, Bruce is off the couch and can work in the yard for a full day without pain. Bruce shared with us that living a pain free life has unlocked the door to a new future. He has lost 45 pounds since the start of the program and can finally enjoy the normal activities he wasn’t able to do.
Download the white paper “How Chronic Musculoskeletal Pain Opens the Door to Opioid Dependency“ to learn more about effectively treating chronic pain so you can prioritize reducing chronic MSK pain and tackle one of your biggest cost drivers, MSK surgeries.
University of Michigan Guidelines for Clinical Care Ambulatory http://www.med.umich.edu/1info/FHP/practiceguides/back/back.pdf
Partnership for Solutions. Chronic Conditions: Making the Case for Ongoing Care. September 2004 Update. Available at: http://www.rwjf.org/files/research/Chronic%20Conditions%20Chartbook%209-2004.ppt. Accessed on April 17, 2007.