New Study Highlights Widening Benefits of Virtual MSK Care

The Peterson Health Technology Institute (PHTI) recently published a study that reviewed virtual technologies aimed at improving outcomes and lowering costs for musculoskeletal care (MSK) conditions. See Study

Why are Virtual Solutions Needed?

Patients, payers, and providers are seeking to minimize unnecessary MSK treatment and there's been a concerted effort to prioritize conservative non-surgical approaches like physical therapy (PT) for various MSK conditions before considering surgical options. But many individuals who might benefit from in-person PT services don't pursue them because of concerns about cost, inconvenience, or accessibility. Limited transportation options, mobility issues, or scheduling constraints further limit access to in-person PT visits. Virtual MSK solutions can improve patients' overall health outcomes and reduce reliance on costly interventions such as imaging, medications, and surgery.

The solutions reviewed in the study fall into three categories:

• Virtual: App-based exercise therapy solutions that provide self-directed exercise therapy using ai and computer vision analysis with limited PT involvement once an exercise program is established.
• Hybrid: Physical therapist-guided solutions that offer virtual PT with a higher level of clinical involvement when onboarding participants, designing exercise therapy regimens, and managing MSK care.
• RTM: Remote therapeutic monitoring (RTM)-augmented PT solutions supplement in-person PT with virtual care.

Key Findings

Virtual MSK solutions can deliver clinically meaningful improvements in pain and function compared with traditional care (which generally includes physician visits and pain management but not PT consultations) for people with a range of MSK disorders. However, PT-guided and RTM-augmented PT solutions can significantly reduce downstream healthcare utilization, such as surgeries, injections, specialty visits, and imaging. The study concluded that if 25% of people with low back pain shifted to any of the MSK platforms (PT-guided or RTM-augmented) at a price of $995 per year, it would save an estimated $4.4 million per 1 million commercially insured individuals.

Although virtual solutions can improve access, particularly among older and rural populations or individuals who cannot easily get to in-person PT clinics, Hybrid or PT-guided solutions may improve adherence and speed up the initiation of therapy, resulting in an even greater reduction in healthcare for MSK. These solutions may also perform comparably well to in-person PT across most major indicators and, for some people, work as a reasonable substitute for in-person care.

Recommendations

The Study makes some recommendations employers, providers and payers to create greater adoption of these MSK solutions:

• Better integrate virtual MSK solutions into medical benefits, not wellness programs;
• Encourage more PT-first MSK care;
• Create value-based payment arrangements that build on the economic benefits of these solutions; and
• Develop solutions to improve patient triage and build evidence for moderate and high complexity MSK care.