Economic Impact of Digital Musculoskeletal Care Versus In-person Physical Therapy: A US Claims Analysis of Health
Ana P Pereira1, Andrea M Seet1, Dora Janela1
1Sword Health, New York, NY.
Objective:
To evaluate health care utilization and spending of individuals enrolled in a musculoskeletal (MSK) digital care program (DCP), compared with those who initiated in-person physical therapy.
Design:
Economic retrospective analysis of comparative matched-group cost-savings from a payer perspective.
Setting:
Health care claims data from a commercial platform, through a deidentified US data set spanning March 2022 to October 2024.
Participants:
Adults (≥18y) with an MSK-related index event between March and October 2023 (N=4,366). The intervention group enrolled in the DCP, and the comparator group initiated MSK-related in-person physical therapy.
Interventions:
The DCP included biofeedback-mediated exercise, education, and behavior change, asynchronously managed by a physical therapist. In-person physical therapy was detected through physical therapy evaluation claims.
Main Outcome Measures:
Total health care and MSK-related utilization and costs 12-months preindex and postindex were compared between groups. Comparability was ensured through exact and propensity matching. Subgroup analysis stratified by acuity was performed. Intervention group self-reported clinical outcomes were evaluated.
Results:
Matched groups included 2183 patients each. The digital intervention was associated with annual per-person savings of $2025.7 in MSK care (95% CI, 1362.0-2689.4; P<.001) and $2369.5 in total health care (95% CI, 1305.4-3433.7) versus comparator group. These were mainly driven by surgery avoidance, imaging, and medical office visits, with generally consistent patterns across acute and chronic MSK conditions. The DCP executed a larger number of sessions and had significant clinical improvements and an estimated $518.1 (95% CI, 480.5-555.7) in productivity-related savings per patient at program-end.
Conclusions:
This study showcases that a fully remote, digital MSK program is able to drive significantly lower health care utilization and spending, mainly by avoiding care escalation into invasive, high-cost interventions. The results highlight the potential of digital-first models to scale value-based MSK care.
Related Concept Videos
01:29Issues And Trends In Healthcare Delivery System
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
01:30Current Trends in Nursing II
01:30Methods of Documentation VII: EMR
01:30Health Information Technology and Healthcare Information System
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...