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For people with a range of musculoskeletal (MSK) conditions, many virtual physical therapy options can result in clinically meaningful improvements in pain and function while reducing overall health care costs, according to a new independent evaluation by the Peterson Institute for Health Technologies.
According to PHTI’s review of the scientific literature, many of these options offer patients clinical benefits comparable to in-person physical therapy, while also improving access, reducing health care costs, and appealing to consumers through convenience.
One in three people in the United States suffers from MSK disorders, which are a leading cause of disability and account for approximately 10% of health care costs. According to the report, these symptoms interfere with patients’ daily lives, affect their productivity, limit their ability to work or earn a living, and contribute to mental health problems.
Since 2010, more than $38 billion has been invested in companies offering MSK options, including mergers and acquisitions.
What are the implications?
The report assessed the clinical and economic evidence for eight virtual MSK solutions in three categories: app-based exercise therapy with limited physiotherapist involvement, physiotherapist-led solutions that replace in-person care, and services that complement in-person physiotherapy with virtual care and are paid for as remote therapy monitoring (RTM).
These technologies typically use body-worn motion trackers and/or cameras to guide patients through exercise and provide customized feedback. The technology products evaluated are sold by publicly traded and private companies, including DarioHealth, Hinge Health, Kaia Health, Limber Health, Omada Health, RecoveryOne, Sword Health, and Vori Health.
The analysis used an evidence-based framework and a review of more than 2,000 papers, including 53 submitted to PHTI by companies assessed in the report. PHTI received input from a range of experts and individuals, including qualified physiotherapists, clinical advisors, MSK patients and other stakeholders.
Survey results show that therapist-supervised techniques offer the most promise and overall value as they provide equivalent patient pain improvement and function to in-person therapy, with a net reduction in expenditures. For many conditions, therapist-supervised techniques are a good alternative to in-person therapy. Companies in this category include Hinge Health, Omada Health, RecoveryOne, Sword Health, and Vori Health.
In terms of economic impact, the report estimates that if 25% of in-person physical therapy users with low back pain were to migrate to these platforms at a cost of $995 per year, it could result in annual savings of approximately $4.4 million per million commercially insured patients.
Other findings include that app-based exercise therapy, including DarioHealth and Kaia technologies, shows improvements in pain and function compared to usual care, but is not effective as a complete replacement for in-person physical therapy. However, it could be an effective solution to deliver a broader range of virtual care to less severe patients who may benefit clinically, with economic impacts varying by price point.
At the same time, although the evidence base for RTM-enhanced PT solutions used between in-person therapy sessions is limited, studies have shown that this category may provide better clinical outcomes in terms of pain and improved function compared to in-person physical therapy alone. However, even when considering the health benefits these technologies can promote, annual healthcare costs are estimated to increase as savings from reduced utilization do not offset increased claims.
Larger trends
Virtual MSK technology companies aim to improve access to PT, but their current business model is structured as an employee health benefit separate from medical benefits and expenses.
This makes it more difficult for companies to quickly identify patients who would benefit most from treatment and use their technology to reach them earlier in the treatment process, according to the PHTI research.
According to the report, virtual MSK solutions could provide even greater value by integrating into medical benefits, encouraging earlier PT referrals and proactively managing other avoidable health care utilization.
Jeff Lagace He is the editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.
