Musculoskeletal (MSK) conditions, including neck and back pain, make up the largest portion of medical expenses for self-funded plans. Lower back pain alone results in 2.6 million emergency department (ED) visits in the United States each year.
MSK care is often highly medicalized and interventional using excessive diagnostics, treatments without clear evidence and with high cost and little outcome data.
Imagine if you have a turnkey solution that provides a telehealth based triage service for diagnosis & early management advice from MSK specialists, and guides your people to right treatment first time. A solution where costs are clear in advance and treatment options are easy to compare. A solution that focuses on better outcomes and surgery avoidance, where our concierge takes your people through a high-value journey – combining white glove service with the gold standard of MSK care.
Comprehensive MSK solution
Sprite Health is your comprehensive solution for musculoskeletal benefits. We work with self-funded employers to design simpler, lower-cost, higher-value musculoskeletal benefits to address back, neck, knee, and hip pain.
Our model provides a single point of access for all MSK issues, ensures members are directed to the right treatment first time, ensures members are given choice over secondary care, reduces inappropriate surgery and measures outcomes. The solution seamlessly integrates with your other benefits, delivers better health outcomes while significantly lowering costs for both employers and employees.
Built on an AI-enabled digital platform, a high-touch concierge service, clinical support & expertise and a curated high-performing MSK network – this turnkey solution transforms musculoskeletal care by identifying employees with MSK issues, guiding them to the highest quality care and engaging them throughout the care journey.
Reduce waste and save money
Sprite health reduces costs by optimizing employees’ musculoskeletal care utilization and eliminating waste in care delivery.
Our system constantly analyzes the MSK concerns and related needs of your employee population and predicts those who aren’t yet, but are likely to become new high-cost members – “cost bloomers”. Once identified, it suggests precisely targeted interventions that maintain good care and help avoid their cost increase.
To optimize care utilization, we focus on reducing avoidable and inappropriate care by replacing high-cost, low-value care with high-quality care from a high-performance network that delivers superior outcomes at lower costs.
Realize better engagement
Our technology provides the connective tissue that blends separate and siloed treatment options in a meaningfully integrated way – delivering the most relevant choices to each employee according to their condition, personal preference and interest. This intuitive approach is both high-touch and high-tech — a single, encompassing portal supported by our concierge that can successfully guide employees on their journey.
To encourage participation, the system precisely targets employees with highly personalized content to match their specific needs – delivered via multiple channels such as email, mobile notifications at the right time.
The smart plan design aligns copays with value that improves utilization of high-value services and discourages the use of inappropriate, intensive surgical options.
Built around your people
Because everyone is different, we customize the benefits ecosystem around each employee’s personalized needs. Anchored by our concierge team and technology platform – we make it simple for members to connect with resources to help them with a wide set of needs, whenever and wherever they want.
Each member has a designated care coordinator who uses a proactive and collaborative approach to help her get the right care using the right benefit from the right provider at the right price, at the right time.
One of our core values is true member choice. We believe involving the member in each stage of their pathway is fundamental to guaranteeing members are satisfied. We actively empower each member to contribute to their clinical discussions regarding their care as we want to ensure it is the right decision for them. Our care coordinators educate members on different treatment options, provide personalized guidance & support and help them make more informed decisions.
Pay for value
Sprite health works closely with you to identify network needs, fill provider accessibility gaps and build a network based on value.
We are committed to working closely with our high-performance network built with therapy, diagnostics and secondary care providers. Our network providers are reimbursed with payment models that promote high-quality and cost-effective care. The value-based payment models (such as pay for performance, risk-adjusted care, severity-adjusted bundles, shared savings, or ACO contracts) reward providers for good outcomes and high quality, not medical errors, unnecessary procedures and other low-value care.
We take over the administrative and compliance challenges of MSK care, allowing your organization to focus on something more important — your employees.
Sprite health brings form, discipline, and structure to plan administration processes using easy-to-use, rapid and automated workflows for enrollment, eligibility, invoice reconciliation, and payments. Our operations team is committed to delivering service excellence. Whether it is the processing of a claim or the handling of an incoming service phone call, we strive to exceed our performance standards.
Services include claims administration, provider relations and reporting, as well as provider and member call centers.