Half of Americans experience a musculoskeletal (MSK) episode each year, accounting for nearly $380 billion in healthcare spending. To combat these costs, employers seek innovative solutions to help employees reduce pain, avoid unnecessary surgeries and reduce costs when surgery is necessary.
We talked to Laura Wallace, Director, Total Health, at ArcBest; and Alexandre Droulers, SVP, General Manager, Thrive, at Sword Health; about how employers can reduce surgeries by providing virtual physical therapy (PT) and access to high-quality surgical care. Lindsey Conon, Chief Customer Officer, Employer Direct Healthcare (EDH), moderated the webinar.
A few key takeaways:
- Employees are frequently steered toward ineffective interventions for MSK pain
- PT should be the first line of defense against MSK pain, but high-quality surgery is also important to improve access to
- Tackling this problem starts with engaging employees with the right care at the right time
A Systemic Issue
Alexandre kicked off the discussion by explaining the true impact of MSK disorders on workers, employers and plan sponsors. On a single day, 50 million people in the U.S. experience an MSK issue. Healthcare costs for MSK result in more than $380 billion spent annually, which is 40% higher than the cost of treating cancer and diabetes combined.
“It’s a very striking number when it comes to realizing what we go through in our day-to-day with pain, what we see with our colleagues,” he said. “It’s a very systemic issue in the U.S. healthcare system.”
Alexandre said in many cases physical therapy can resolve MSK issues, yet employees are often steered toward different interventions, such as opioids, injections, imaging and surgery.
“The solution should be a first layer of preventive, clinically proven physical therapy. And when you do need surgery, then going with the highest-quality surgery network,” Alexandre said. “But today, that’s not happening. This two-layer system of preventive MSK and high-quality surgery doesn’t happen.”
Employees face additional barriers to accessing quality PT and surgical care. Nearly 60% of insured Americans report delaying needed care due to cost, while many people live in healthcare deserts or struggle to navigate the complexities that come with surgery.
“The average consumer doesn’t know how to find a quality provider, or the right provider for their treatment journey,” Alexandre said.
Searching for Solutions
Laura mentioned how ArcBest, a leading logistics company, solves global supply chain challenges for its customers. They also take a similar problem-solving approach to improving healthcare access for their employees.
“Wellness is a core value for ArcBest, so we started to think about how we can make that journey easier for our population of 50,000 employees in all 50 states,” Laura said.
ArcBest lacked nationwide access to quality care, and their data suggested that employees were often turning to surgery to treat pain. MSK was their No. 1 spend category.
After vetting several solutions, ArcBest chose Thrive, a virtual physical therapy solution from Sword Health. Employees can engage directly with Sword to see if it’s the right fit and they don’t need to visit a PCP first or get a referral.
“Sometimes I think employees assume physical therapy is a barrier to getting surgery, and we’re changing that conversation to ‘No, physical therapy through Sword could be the solution, not a barrier to getting surgery, and it’s much less invasive and easier to do,’” Laura said.
Not long after implementing Thrive, Laura began looking for a surgery partner that could provide a quality solution at scale to their dispersed workforce.
“You can look at the best hospital system in the country, and they’re still on a bell curve,” Laura said. “They still have low-performing providers and high-performing providers and people in the middle.”
SurgeryPlus appealed to ArcBest because our robust screening process vets surgeons based on training, outcomes, protocols and more, so only the most qualified surgeons are included. Plus, nationwide coverage places 98% of SurgeryPlus members within driving distance of their surgeon, so ArcBest employees have access to care wherever they are in the U.S.
“It’s helpful to find a solution like SurgeryPlus, which ensures members receive the best quality care with fewer complications and lower prescribing of opioids and pain medications,” Laura said.
Creating a Continuum of High-Quality Care
As ArcBest sought out solutions for PT and surgery, the goal was to create a continuum of care for employees where vendors work together collaboratively, not roll out disparate point solutions, Laura said.
“We’ve heard how SurgeryPlus has recommended Sword after surgery to do physical therapy, and I said, ‘Yes, that’s exactly what we want our vendors to do,’” Laura said. “We not only want great relationships with our vendors, but we also want them to have partnerships with each other, so they’re cross-referring and recognizing each other as trusted partners.”
With the ArcBest model, physical therapy serves as the first line of defense for managing pain. When surgery is truly necessary, members receive surgical care from a strong network of providers focused on quality, member experience and affordability.
“An employee using Sword and SurgeryPlus pays zero dollars out of pocket, and it’s a lower cost to the plan as well because we’re using SurgeryPlus as a center of excellence,” Laura said. “That means lower complications, and savings on the bundled packaging. It’s really a win-win for everybody.”
$850K Savings, 92 NPS Score
Since offering Sword and SurgeryPlus, Laura said employees champion the benefits and help drive engagement. To date, SurgeryPlus enjoys a world-class NPS score of 92 at ArcBest.
“It’s all about the member stories and testimonials from employees who have used the services,” Laura said. “They’ll share their experience, and then other employees say, ‘Oh, I didn’t know we had these benefits, that’s great to know.’”
In 2023, ArcBest saved more than $850,000 on surgery, which accounts for almost $14,000 in savings per procedure and $17 per employee per month.
Since implementing virtual physical therapy via Thrive, ArcBest has saved $576,000 and seen an ROI of 3.2x, while improvements in clinical outcomes include a 39% reduction in surgery intent, 53% reduction in pain levels and a 26% reduction in lost productivity.
“In 2021, MSK spend was our No. 1 condition,” Laura said. “Looking at 2024, MSK is annualized to be ranked as our fifth-highest-care spend, which is about half of what we spent on MSK in 2021. I was really happy to be able to share that with our leadership last month.”
Watch the full webinar on demand.
If you want to learn more about improving care access and reducing costs at your company, get in touch with us.
