Musculoskeletal (MSK) conditions remain a leading driver of healthcare costs in the U.S., particularly as Medicare Advantage populations continue to age. Many health plans face persistent cost and variability tied to surgical and downstream interventions. This white paper examines how shifting away from high-cost surgical pathways impacts utilization, overall spend, and return on investment.
Surgical avoidance drives significant savings, with 132 fewer surgical encounters per 1,000 members resulting in $2,715 per-member-per-year in surgery-related savings.
Downstream reductions further amplify savings with decreases across rehabilitation, imaging, office visits and emergency care.
Members aged 65+ actively engage and complete programs, averaging 33 sessions, finishing at higher rates than younger cohorts.
Propensity score matching across 81 covariates and a difference-in-differences design means the 4.7x ROI reflects real population impact, not favorable selection.
