4 tips to get employees’ attention to digital musculoskeletal program

The COVID-19 pandemic has disrupted our lives in multiple ways — from constant fears about health and finances to most employees still working from home. The lines between work and life are blurred. Work from home trend is likely to continue in the future. A recent report from CISCO suggests that more than 75% of large organizations (typically self-funded) will increase flexibility to work from home. 

Benefit leaders know that health of their people is the first priority. If employees are in pain or are sick, they are not productive. To perform well during this pandemic, employees need to know they can get quality care from their safety of their home, when they and their family members need it.

By offering digital health, benefit leaders are helping their team members get access to primary and urgent care via phone, message or a video call. This keeps them away from high-risk health clinics and hospitals. While telehealth for primary care can address minor urgent care issues such as cold and flu, allergies, sore throat, UTIs etc., the transactional model of telehealth is not effective for chronic condition management and musculoskeletal care.

People with chronic conditions such as chronic back and joint pain often require multiple visits with their providers and need close monitoring on a regular basis. They also need an ability to have asynchronous model of communication with their provider between visits. Understanding this need, progressive benefit departments are taking the next step and offering digital therapeutics for conditions such as digital care for people with musculoskeletal pain. Some companies have committed to providing such programs at low or no cost to their people. Such a move will be a significant factor in maintaining a culture in which team members feel supported and safe.

Having digital health in your benefits portfolio is not enough. It is also equally important that people know about it when they need it. Scheduling health fairs, in-person meetings, and accessing cafeterias or break rooms to promote health benefits programs is no longer realistic. In this new ‘reality’ benefit leaders will no longer be able to rely on place or time based (for example during open enrollment only) approaches to get employees’ attention to their benefits. It is no surprise that during this open enrollment benefit leaders are feeling more pressurized to provide strong  communication, education and support of the health benefit programs, while relying on new forms of communication. 

Here are  5 tips to up your game to find new, engaging options that work in an at-home, virtual environment.

Create personalized, targeted communication

With employee stuck at home, most of them are experiencing information overload and spending on average over 50 -60 hours per week consuming social media content.  The way your people are consuming information has changed. They are now expecting the information they are interested in to find them rather than having to look for it.

Most traditional benefit communication followed the broadcasting model: One-size-fit-all and send the same content to everyone. Gone are the days of sending a boring and generic ten-page email. With people distracted at home, it is more important than ever to make benefit communication employee-centric and tailored to meet their individual needs. Benefit leaders should expect that at this time, anything which is irrelevant to recipients will be ignored.

We can’t ignore the differences in impact that Covid-19 has had along the lines of basic variables between employees – e.g., essential vs non-essential, remote vs. non-remote workers, the presence of dependents at home, gender, socioeconomic level, and ethnicity. Even with widespread popularity of digital health in a short period of time, the access remains very uneven, in terms of addressing all populations.

The new of the hour is to tailor communication to smaller, more selective audiences (even individuals). Seek opportunities to segment messages, even to significant groups.

Make it relevant, simple, straightforward, and interesting.

Round the year messaging

It is also important to continue benefits communications beyond the annual open enrollment period. The importance of employee engagement round the year cannot be understated, amidst a shift to virtual and remote work, which will continue to be more commonly practiced. The needs of employees change throughout the year. The communications strategy should accommodate all life changes and allow employees to make benefits changes as needed during the year.

When you’re looking into how to engage remote employees and keeping remote employees engaged, remember that it’s a constant task to nurture and develop. Engagement is never a one size fits all approach or something you do once in a blue moon. Keeping remote employees engaged turns them into your best and biggest asset. 

Use the right tools, first and foremost

If your team isn’t using the right tools to communicate and collaborate effectively then you’re already starting off on the wrong foot. The market has a ton of chat and collaboration tools to choose from so managing a robust, productive remote team is a much easier task to take on. 

If your workplace is not digital yet (your Intranet is outdated, you’re still sending out standardized email newsletters to your entire workforce, or you don’t use any employee communications app that allows your employees to personalize their newsfeed), you’re going to have a tough time engaging with your remote employees. You need to build a robust internal communications strategy that helps you connect and engage with the remote workforce. Put differently, you need to shift your internals communications toward a digital communications ecosystem.

Also video is preferred over text. Much of our language is nonverbal. When managers are forced to limit the nonverbal cues available to their direct reports, they increase the chance for miscommunication, defensiveness, and conflict. Managers need to communicate with their teams in multiple ways and through multiple mediums to keep expectations clear, to reinforce priorities, and to help understand and address barriers to maximizing their team’s work while they are away from the office.

Whether it’s through their phones, a news feed similar to their social feeds, or a content booster they can use to suggest and share content, you’ll need to find the right channels to communicate with them.

Make sure employees feel heard and valued.

However, in most organizations, top-down communication translates into standardized and noisy communication. Most experts agree that top-down communication alone is not the best approach to drive engagement in the workplace

Frequent group updates and anonymous feedback surveys can also help a remote workforce feel included and give them the opportunity to voice their needs without the added concern of reaching out at an inopportune moment.

Create an effective communication strategy so you can reach every employee. For example: 

  • Hold weekly formal “check-ins” 
  • Establish performance goals for the month, quarter, and year
  • Set clear expectations and requirements for tasks
  • Channels should be created for each situation such as one-to-one chats, team meetings, video calls, or open forums for sharing of feedback and ideas
  • Encourage two-way communication – get feedback on projects, marketing strategy, customer satisfaction, and more.

Your employees deserve to feel appreciated – even from a distance. Since you’re not in the office with them each day to extend a quick thank-you or take them out to lunch for their work anniversary, you should find small ways to celebrate your employees as often as possible. 

Sprite Health’s digital musculoskeletal program provides a single point of access for all MSK conditions, across the entire MSK continuum. Our virtual physical therapy services provide a more affordable and convenient way to prevent and treat pain. Chronic pain management provides an evidence-based, PT-led digital program for chronic joint and back pain that includes personalized exercise therapy, behavioral health support, education & guidance. Bundled surgery provides access to high-quality musculoskeletal surgical care at a pre-negotiated bundled rate. MSK financial management leverages predictive analytics, clinical expertise and plan administration capabilities to eliminate waste – resulting in over 30% net savings in your MSK spend.

7 health plan barriers to quality musculoskeletal (MSK) care

There’s a good chance that as you read this during COVID-19 pandemic, you’ve got a pain in your neck, lower back pain or stiffness in one of your joints. Millions of people are experiencing new or increased back, neck, or shoulder pain since they began working from home because our homes are not necessarily designed to support long working hours.

Even before the pandemic, musculoskeletal (MSK) conditions have been the leading cause of disability in the United States (US), affecting one in two adults.

The evolving work-from-home economy is likely to increase this number in a significant way. For self-funded employers and health plans, this means escalation in cost attributed to musculoskeletal (MSK) pain. MSK is already one of the top cost categories for many employers, costing as much as 15%-20% of the overall health spend. Majority of MSK spend (82%) is on surgeries, and associated imaging. Given that our healthcare system is highly fragmented, medicalized, interventional, volume-driven with huge price variation between providers – over 50% of the musculoskeletal spend is wasted. The employers and health plans are getting poor return on their musculoskeletal investments.

It does not have to be like that. Conservative treatments such as physical therapy, chiropractic care and other rehabilitation services can effectively address the pain and functional limitations that typically accompany MSK conditions. For example, research has shown that early physical therapy intervention is associated with faster healing, reduced health care utilization and reduced overall health care costs.

Despite evidence and proof points, employees often don’t seek out the conservative musculoskeletal services as often as they should, nor are they encouraged by many primary care physicians or specialists to explore such options. That’s why it is not uncommon for people to start the therapy for back pain after 5 months from onset of pain, or 3 weeks after ankle sprain.

In addition to lack of awareness, access to conservative care is often made challenging due to many barriers. In-person care is limited to 9-5 schedule, 5 days a week. There is a wait for initial appointment, and since physical therapy or chiropractic manipulation regimen require frequent visits – taking time off work, travel and arranging for child care is not realistic. On top, the strange out-of-date benefit plan designs make out-of-pocket costs (for therapy) prohibitive for employees. Employees are often unaware of changes in their benefit plans from year-to-year, particularly for unexpected new onset conditions.

Physical therapy coverage in health plans

Physical therapy helps injured employees improve movement and manage pain. It is often an important part of preventive care, rehabilitation, and treatment for members with chronic musculoskeletal conditions, illnesses, or injuries. Most health plans in United States pay for physical therapy services that are medically necessary and that are provided by or under the direction and supervision of a physical therapist. 

However just because the health insurance plan covers physical therapy doesn’t necessarily mean that the plan will pay 100% of charges when an employee gets the treatment. In many cases, employees still have to pay a deductible, a co-insurance, or a copayment. 

How much does physical therapy really cost?

If your health plan covers physical therapy, the amount of money you or your health plan will spend depend upon a number of variables including

  • The type of therapy
  • The length of each therapy session
  • # of sessions
  • Your provider
  • The setting of service
  • Medical supplies or equipment

The cost of physical therapy can easily add up since it is not something that works in one visit but usually requires several visits. Obviously if your rehab requires more visits, you will end up paying more and yes, there is variation in pricing between providers.

The setting of service is very important to know. Physical therapy in a hospital setting will cost more than in the clinic. Digital (virtual or remote) physical therapy is the lowest cost option. Medical supplies is another cost component. No different than how you pay for a chocolate in the hotel room’s minibar. Same product, but much higher cost if you purchase it in the clinic vs. buying it from Walmart.

If you’re going to pay out of pocket for physical therapy, expect to pay an average of $125 per session. This is not the entire story though. While physical therapy is not much expensive on a per session basis, it is not cheap when you add the overall cost for the duration of the treatment and the numbers quickly add up. According to The American Physical Therapy Association (APTA), physical therapy for chronic or lower back pain costs $126 per session with most spending between $1,000 and $1,260 for around 8 to 10 sessions of treatment over six weeks. Another study from 2015 showed that members could pay $2,807 to $3,376 for up to 36 PT appointments following rotator cuff surgery.

Is physical therapy still worth it?

Absolutely yes. For 90% of MSK conditions, physical therapy is the right place to start. The clinical diagnostic accuracy by physical therapists matches with the orthopedic surgeons on patients with MSK injuries, at 1/25th of the overall episodic cost (when measured over 12 months).

For the remaining 10% cases, physical therapists can provide the assessment, guidance and triage to the right alternative treatment.

Physical therapists are also more accessible. It takes 1-2 days to schedule an appointment with physical therapist vs. 1-2 weeks with a PCP or a specialist.

THE BARRIERS

Why aren’t health plans and employers making therapy services more accessible — despite the overwhelming evidence that physical therapy is both clinically effective and cost-efficient?  After all health plans, employers and providers want the same thing – to help members achieve optimal health outcomes and avoid dangerous, costly treatment that could result in further complications down the road. 

This accessibility problem is a result of poor health plan designs that have been carried over from time immemorial. In particular, cost-sharing requirements imposed by the health plan often do not reflect the true value of different treatment options available. Making high-value musculoskeletal services more accessible requires health plans to get rid of the legacy barriers that are getting in the way.

Barrier 1: Deductible

The deductible is the amount a member pays out of pocket before her health plan will cover any portion of her physical therapy visits. Let’s say your plan’s deductible is $1500 and you visit your physical therapist six times within the first two months of health plan enrollment, and the allowed amount paid to physical therapist per visit is $300. In this hypothetical scenario, you will have to pay the full bill for the first five visits and less for the sixth (copay and coinsurance may still apply after you have met the deductible).

From a health insurance perspective, it may make sense that when members are the first party to the loss (insurance jargon) in form of deductible, they will be very selective in using health care and pick only high-value. However research has proven time and again that deductibles get in the way of high-value care (for example preventive care or using PT for musculoskeletal conditions) as much as low-value care (for example visiting ER for low acuity back pain). When in doubt people stay away from both high-value and low-value care. Also because deductible resets every year, for someone who has been carrying pain from previous plan year faces enormous barrier in a new plan year, which does not make any sense. This poorly implemented plan design concept encourages some people to make irresponsible decisions after their deductible is met.

Barrier 2: Copay

A copay is a flat fee you pay for each visit. Your health plan determines the copay amount that you pay for each physical therapy session. Over the last few years, in an effort to keep member insurance premiums low—health plans have shifted a greater portion of the physical therapy cost to the member. As a result, copays have steadily increased.

The right copay for physical therapy is between $0 and $20 and members with copay over $30 are 29% less likely to see the PT than the ones with $0 copay.

Unlike regular physician visits, physical therapy regimen requires multiple visits based on the type of injury or pain. Having a high copay (over $20 per session) end up discouraging members from seeking rehab therapy care due to the high overall out-of-pocket cost.

As a result, this makes it harder for members with musculoskeletal conditions to achieve optimal care outcomes—which ultimately leads to poorer overall health.

Barrier 3: Coinsurance

The coinsurance is a type of out-of-pocket payment that is calculated as a percent of the total allowed amount for a particular service. It’s the member’s share of the total cost. For example, let’s say:

  • your health plan’s allowed amount for a physical therapy session is $200;
  • you have already met your deductible
  • you are responsible for a 20% coinsurance.

In this scenario, you will owe $40 at the time of service, and the health plan would pay the rest of the allowed amount for that visit. Coinsurance amounts may vary from visit to visit—depending on what services you will receive and that’s what the problem is.

Unfortunately you don’t always know in advance what services you will be receiving in any visit and hence you have no idea what % of what amount you’ll be responsible for. It is only after the visit, the services (and devices, products) are added to the provider’s claim, which is sent to health plan for adjudication, a managed care discount is applied, a cryptic EOB (explanation of benefits) is generated and sent to you 1-2 months after the visit with some details on what you owe.

Co-insurance is a simple concept to understand, but because of the way services are priced and paid, it is not transparent and discourages people from adhering to their treatment plan.

Barrier 4: Arbitrary Limits

Most health plans place a limit on the number of physical therapy visits (typically 20 visits) they’ll cover in a benefit period. The main idea behind this is to reduce inappropriate utilization. However this idea is fundamentally flawed.

These arbitrary limits per year do not account for initial diagnosis or severity, variability in rehabilitation progress, or complications. The number of sessions (and recovery time) you need depends upon the type of injury, complications and severity. 8-10 sessions may be good enough to recover from knee replacement but physical therapy for rotator cuff injuries can take as many as 30-40 visits over 3 – 6 months of recovery.

Some health plans put a combined limit across multiple unrelated services that includes physical therapy, speech therapy, pulmonary rehabilitation etc. This is really a dumb idea when you think about the plan design from a member’s perspective.

Instead of imposing an arbitrary limit, the benefit plan’s coverage should be designed to facilitate restoration of function. An appropriate physical therapy benefit should include the care coverage that allows an individual to return to his or her previous level of function.

Barrier 5: Referrals

Even though the physical therapy as the first line treatment provides the highest level of diagnosis for over 90% of musculoskeletal (MSK) issues and most states now permit direct access to licensed physical therapists for evaluation and treatment without a referral from a physicians, less than 10% of visits for first line treatment are made to PT.

Most members go to PCP, specialists or ER/Urgent care for first line treatment which initiates diagnostic testing, follow-up visits, medication prescriptions, and then finally a referral to a physical therapist. These visits and tests, as well as the pain medications delay the start of rehabilitation, ultimately hindering care.

On the contrary, requiring a physician referral for physical therapy services for a primary MSK complaint actually increases costs. Not all PCPs are up-to-date with latest in musculoskeletal care and the referrals are often dependent on the physician’s knowledge and attitudes toward MSK evaluation and their interpretation of the clinical guidelines for involvement of therapy or rehabilitation services.

Barrier 6: Pre-certification or Prior Authorization

Pre-certification or prior authorization is a utilization management review decision where a health plan determines whether a therapist’s choice of treatment is the best decision for the member based on plan’s clinical guidelines.

The health plan guidelines may vary from one year to another and decisions on pre-authorization requests generally take up to 1-2 weeks. This slow archaic fax-driven process hampers member access to care and negatively impact member outcomes.

Instead of blanket policy where all requests have to go through pre-authorization, health plans can deploy machine learning tools to a) identify efficient providers from inefficient ones and b) high-value vs. low value services and c) allow efficient providers to prescribe high-value services without any prior authorization requirement.

Cook et al have demonstrated that patients who report 50% reduction in pain in the first 2 weeks of a PT plan of care have a significantly greater likelihood of reduced disability at 6 months. This logic can be applied to waive the need of pre-certification for the first 3 visits or 2 weeks of treatment. If the member needs additional sessions, the PT should be able to justify it based on the results from initial treatment. This collaborative relationship between therapist and health plan can improve the health care outcomes for the member.

Barrier 7: Inadequate coverage for digital musculoskeletal (MSK) care

Let’s accept it. The Monday through Friday, 9-to-5 model of in-person therapy that happens within the four walls of a physical therapist’s clinic was no longer working for the majority of people even before the COVID virus arrived. Virtual physical therapy, also known as remote, mHealth, e-health, mobile therapy is vital now, particularly given the challenges we face in healthcare today.

Virtual physical therapy is more convenient, accessible and effective than in-person alternative for most people. Members get care in a familiar setting with convenient hours and location. And when members and therapists are communicating, there’s always an opportunity to close loops if someone’s not doing as well as they should be.

In addition, the use of digital health technology addresses access issues due to distance, availability of providers and specialists, impaired mobility, and lack of transportation, especially for BIPOC population. In the virtual care model, the connection can be in “real-time” as a live interaction or asynchronous. Much more so than with traditional care, virtual musculoskeletal care includes a larger educational component. Because the therapist is not physically present to assist with movements or joint stabilization, the onus is much more on the member to learn these techniques and practice them continually.

Despite several years of pleading, it was only in march 2020, CMS and commercial payers decided to add virtual physical therapy to the list of services they would cover during the pandemic. The payments for such services at this time is kept the same as for an in-person visit. The health plans should ensure that this new model of member-centered care that leverages advanced cloud technology to deliver better health outcomes at a lower cost is covered in future on a permanent basis.

THE RIGHT PLAN DESIGN FOR MUSCULOSKELETAL CARE

The right health plan design for an employer is not a cookie-cutter plan offered by the carrier, but a custom plan built around its employees – more specifically the condition and needs profile of its employee population. If an employer has high rates of MSK conditions in its population or if musculoskeletal spend is one of its top cost category, the health plan must cover high-value treatments that have proven to be effective for these conditions.

An effective plan design incorporates the principles of value to determine cost-sharing. The value is generally determined by the effectiveness of the procedure or treatment and benefit to the member in relation to overall cost. Value-based insurance design (VBID) is one such model that recommends lowering or removing financial barriers to essential, high-value clinical services and aligning members’ out-of-pocket costs, such as copayments and deductibles, with the value of services.

Amid an environment where there seems to be a high-dollar treatment for every musculoskeletal (msk) condition, it’s remarkable to consider that relatively low-cost and non-invasive PT is making such a mark on reducing healthcare costs. VBID encourages such low cost options prior to high cost ones (such as trying physical therapy for pain relief prior to having surgery).

A variation of this plan design is where pre-authorization and cost-sharing is waived for the first few visits. This breaks down the initial barriers for the member to access physical therapy in a timely manner. Examples of such plan designs are being tested by various organizations including TRICARE and United Healthcare among others.

TRICARE found out in their research that that rates of attendance to at least one physical therapy session varied significantly, ranging from active duty beneficiaries at a 65% attendance rate to non-active duty dependents only reaching 38% attendance. The low-attending group happens to have the highest cost-sharing requirements for physical therapy. The experiment of cost-sharing waivers is based on an assumption that it could help to increase participation in “high value” treatment for low back pain.

In the United Healthcare model, the physical therapy is offered in a bundle “PT bundle”. Any member with a documented diagnosis of low back pain is eligible for receive up to three PT sessions for a single copay, which is comparable to the typical copay amount for a single PT session.

The value-based PT bundle approach with either waiving cost sharing or a single copay for the bundle represents an innovative application of the principles of VBID focusing on enhanced access to a potentially high-value but underutilized treatment option to treat musculoskeletal conditions that are prone to unnecessary and avoidable care.

Sprite Health’s corporate musculoskeletal program provides a single point of access for all MSK conditions, across the entire MSK continuum. Our virtual physical therapy services provide a more affordable and convenient way to prevent and treat pain. Chronic pain management provides an evidence-based, PT-led digital program for chronic joint and back pain that includes personalized exercise therapy, behavioral health support, education & guidance. Bundled surgery provides access to high-quality musculoskeletal surgical care at a pre-negotiated bundled rate. MSK financial management leverages predictive analytics, clinical expertise and plan administration capabilities to eliminate waste – resulting in over 30% net savings in your MSK spend.

How digital care optimizes the musculoskeletal surgical pathway?

Have you ever called a surgeon’s office for yourself or your loved ones? This is how it goes –

Press 1 if you are a provider, Press 2 to schedule an appointment, Press 3 if you are an existing patient and Press 4 for billing or claims.

There is no option for you to talk to someone who can help you understand the process and explain what is right for you. Someone who is on your side when you are unsure and scared. If you press 2 and schedule the pre-surgical appointment, more than likely you’ll be heading down surgery even if that may not be in your best interest.

Millions of musculoskeletal (MSK) surgeries are performed in United States every year. Most MSK surgical pathways in practice are focused around provider, rather than member’s convenience. There are wide differences in quality and cost among facilities and surgeons who perform these surgeries. Despite the enormous cost of surgery (many of them cost over $50K), unfortunately most members routinely experience complexity and multiple handoffs across different providers. Most often they don’t have any health advocate on their side, and they have to figure things out on their own.

Employers and health plans are awakening to this realization and are demanding better value for their healthcare spend. While bundled payments with centers of excellence (COE) facilities are a great start, much more is needed to make the process better that improves member experience and lowers costs by eliminating waste.

Unlike traditional model of care, digital musculoskeletal care platform takes a member-centered approach to surgery to maximize best outcomes. This means that members are more educated and engaged in their care and recovery, more happier with their care and achieve better functional outcomes, with less complications. In this model, the surgical pathway begins much earlier than the traditional model – it starts when members first contemplate surgery in primary care or a surgical clinic and culminates weeks to months later on the day of surgery.

It’s widely acknowledged that the most important component of successful surgical outcome is what a member does when they are not in the surgery. The digital care program optimizes the musculoskeletal surgical pathway by integrating the following three complementary processes (outside the surgical setting) in the member’s surgical journey.

  1. Shared decision making
  2. Prehabilitation (Prehab)
  3. Rehabilitation (Rehab)

SHARED DECISION MAKING

The only surgery without risk of complications is the one not performed. Shared decision-making (SDM) is a process whereby members and clinicians work together to make evidenced based decisions centered on member’s values and preferences. Shared decision making explicitly acknowledges that there is usually more than one way to treat a problem, including ‘no treatment’. In our fragmented and wasteful system of care, members most certainly require support to understand the benefits and harms of the options in order to determine the best choice for them.

Digital musculoskeletal care program facilitates the shared decision making to ensure that the right decision is made in relation to the surgery and ensure that the member is well prepared for the surgery.

These goals are best achieved if members are guided about their options earlier in the pathway to surgery. Ideally such engagement occurs at the time of initial diagnosis or when the member decides to choose a specialist such as orthopedic surgeon.

At the right time, a dedicated musculoskeletal (MSK) clinician speaks to the member before major surgery (such as total hip and total knee replacement). The clinician enables the member to understand the implications of surgery, ensures that conservative measures have been optimized, surgical thresholds are met and that the member indeed wants surgery and is prepared for it. At this stage, the clinical also explains non- surgical alternatives.

This collaborative approach enables members to be fully informed about their care. Members who are effectively involved in making decisions about their care have fewer regrets about treatment, better communication with their healthcare professionals, improved knowledge of their condition and treatment options, better adherence to the selected treatment and an overall better experience.

Innovative employers such as Walmart have implemented shared decision making very creatively. When designing the payment arrangement with centers of excellence (COEs), Walmart went to great lengths to ensure that the COEs
would be motivated to deliver only appropriate care and cut out waste. The surgery program consists of two separate non-overlapping prospective bundles. The ‘evaluation’ bundle which essentially pays providers for evaluation and guidance and surgical bundle which pays for surgery. This approach helped Walmart mitigate some of the financial incentive to perform unnecessary surgeries for members who should seek alternative treatments.

PREHABILITATION (PREHAB)

A successful outcome begins before surgery. After a member has chosen to go ahead with surgery, prehab or prehabilitation should be the next step of the member’s journey that leads to best outcomes.

It should not be a surprise to anyone that beginning the surgical journey in the best physical and psychological condition helps getting to better surgical outcomes and faster recovery times. Research has indicated that hip/knee surgery patients who undergo prehab are 73 percent less likely to need inpatient rehabilitation. Just one or two sessions of preoperative physical therapy reduced the use of post-acute care services by nearly 30%. Despite mountain load of evidence, very few surgical facilities encourage prehab. Most surgery assistants don’t even know if that exists.

Most elective surgeries in US have months between scheduling and the day of surgery. Ideally, it should begin at least six weeks before an elective surgery (like joint replacement, ACL repair, back surgery, shoulder surgery etc.).

The digital care program for prehab includes interventions such as initial contact with the members to gather relevant information about their readiness. Unlike the traditional approach where the members are pretty much left on their own, in the the digital musculoskeletal program the care coordinator maintains communication with the member throughout the waiting period with regular messaging. The lead physical therapist undertakes a holistic assessment, and identifies any comorbidity that may impact on the surgery. In addition, the members are provided relevant education to improve their physical condition.

Working with a physical therapist, the member receives a personalized exercise program through an engaging cloud-based applications that could be accessed through a desktop computer, tablet or phone. The exercise program is geared towards putting member in the best possible position to recover from surgery. Depending upon the member’s needs, the prehab program may include a weight-loss regimen (especially in the case of joint replacement surgery) or it may simply be focused on strengthening the body.

Prehab also gives members a chance to practice the post-operative exercises they’ll be expected to do during their rehabilitation. Members learn techniques on movements with new weight-bearing precautions or mobility restrictions they’ll likely have after surgery.

Overall, digital musculoskeletal care program for prehab empowers the member to be proactive about the surgery, make her an educated and more well-informed member, and shortens the recovery time.

REHABILITATION (REHAB)

After the member had a surgery, a course of post-surgical rehabilitation will continue the good work they started with prehab. The goal of postoperative rehab is to get you back on your feet, so you can continue living a healthy and independent life. It includes a personalized treatment plan shaped to your individual needs, including the type of surgery you are recovering from and any other medical conditions you may have. Digital care program for rehabilitation often includes three key elements: 

  1. Physical therapy to increase strength, mobility and fitness
  2. Occupational therapy to help the member perform day-to-day activities
  3. Pain management to decrease discomfort

For most members, digital rehab is a better way to get healed after surgery. Even though physical therapy is often uncomfortable right after surgery, it is far less painful than waiting to begin rehabilitation.

Getting started with rehab early after surgery is key. If members see good outcomes early, they feel more confident and optimistic throughout their recovery. In most cases, the digital care program initiates virtual physical therapy within 24 hours of the procedure and may continue for up to three months following surgery.

After the initial assessment of balance, strength, ROM and functional level, the members receives an exercise plan from the physical therapist, that is customized to his or her needs and fitness level. The exercise plans is made up of video exercises in the app, rather than the traditional stick figures provided in in-person setting. The system helps member stay compliant with their treatment. This connected care model enables members to monitor their progress and communicate with their therapist anytime. If a member reports a high pain level, the therapist is alerted. If a member is struggling, the exercise regimen is adjusted. The core aspect of post-surgical rehabilitation is doing the right exercises and the right amount of exercises. The intensity of the stimulation increases gradually and progressively.

In short, digital musculoskeletal care for prehab and rehab helps members retrain and strengthen the muscles, ease them back into daily physical tasks, prepare their body for regular exercise, speed overall recovery, reduce pain, improve mobility and flexibility and prevent new medical problems from forming.

Sprite Health’s corporate musculoskeletal program provides a single point of access for all MSK conditions, across the entire MSK continuum. Our virtual physical therapy services provide a more affordable and convenient way to prevent and treat pain. Chronic pain management provides an evidence-based, PT-led digital program for chronic joint and back pain that includes personalized exercise therapy, behavioral health support, education & guidance. Bundled surgery provides access to high-quality musculoskeletal surgical care at a pre-negotiated bundled rate. MSK financial management leverages predictive analytics, clinical expertise and plan administration capabilities to eliminate waste – resulting in over 30% net savings in your MSK spend.