Other evidence-based MSK treatment options include physical therapy (PT), lifestyle modifications, behavioral health support, and non-pharmaceutical pain relief. Research shows that a multidisciplinary approach with a combination of noninvasive, complementary interventions effectively reduces pain and prevents surgery in 95% of MSK patients who complete treatment. And, when patients use PT within three months of diagnosis, they are less likely to use opioids long term.

One tool that has proven effective in supporting the uptake of evidence-based treatments for chronic MSK pain is digital health. Digital health tools have the ability to expand access to care, identify high-risk patients, educate them on diverse treatment pathways, and provide ongoing clinical support. Increasingly, health plans and plan sponsors are incorporating digital solutions into their benefit designs, while providers are leveraging these tools to guide at-home exercise programs and embed them directly into patient portals.

At the industry level, financial forces keep MSK stakeholders misaligned, preventing them from achieving HVC at scale. Misaligned payment incentives lead health plans, providers, and employers to prioritize cost and quality differently, which can cause clashing approaches to care.

Health plans and plan sponsors are motivated to direct patients to high-value, lower-cost care options, but may struggle to do so in a way that doesn’t feel restrictive to providers and patients.

Traditional MSK care models favor surgery or medication because other evidence-based options are seen as less accessible or effective. And, even though research supports the efficacy of PT and other non-surgical options, greater education and engagement are needed for physician buy-in and behavior change.

Patient perceptions and social drivers of health are also significant barriers to HVC. Evidence-based alternatives, like PT or lifestyle interventions, are frequently seen as barriers that prolong time to surgery. Patients often view surgery, injections, or medications as an option that will provide quicker relief than attending multiple physical therapy sessions and committing to an exercise program.

Healthcare should emulate other industries like banking and retail by integrating in-person and digital services and providing better access to expert support for a cohesive customer experience. This requires breaking traditional silos and uniting the entire patient journey — from entry points to care to treatment recommendations and delivery methods. The result is a unified care model (UCM) that creates a pathway to seamless, multidisciplinary, evidence-based care, supported by personalized treatment and hybrid delivery options.

Advances in treatment and diagnostics offer patients the promise of personalized, tailored care. For example, genetic markers can help predict the onset or progression or certain MSK conditions, and advances in biometric data analysis can help predict a treatment’s effectiveness. This ever-expanding universe of treatment options also increases the complexity of care delivery. The treatments chosen should reflect a patient’s unique needs — in the MSK space this includes their perception of their pain, their ability to follow through on a particular treatment, and their ability to access treatment.

Education: Determining the best MSK treatment starts with a comprehensive understanding of pain. Growing evidence supports the use of pain neuroscience education (PNE) as a high-value approach to communicating with patients about their MSK pain. PNE helps patients learn how the brain and nervous system process pain signals, shifting their perspective from viewing pain as simply tissue damage to recognizing it as a complex interplay between the nervous system and psychosocial factors. Better understanding one’s pain is a proven approach for treating MSK pain, disability, and psychosocial factors. Effectively communicating diagnoses to patients can help build their confidence to participate in their care.

Care options: In addition to a comprehensive understanding of pain, patients need access to comprehensive treatment options. In the traditional, linear care pathway, primary care physicians (PCPs) often play quarterback in directing the MSK care journey. However, studies show that PCP-led triage often results in suboptimal diagnosis, unnecessary imaging, and fragmented treatment. Instead, research indicates better patient outcomes and higher satisfaction when orthopedic specialists or physical therapists manage care, resulting in more timely treatments and fewer instances of LVC.

Offering access to a multidisciplinary team — including physical therapists, physiatrists, behavioral health specialists, lifestyle coaches, and more — empowers patients to choose who oversees their treatment. This choice enhances patients’ understanding of comprehensive treatment options and encourages active involvement in care decisions. Additionally, trusted care managers build patients’ confidence, motivating them to explore new treatment options and connecting them with a network of highperforming providers.

High-performance network: Access to quality, multidisciplinary care requires action from crossindustry stakeholders to connected patients to the best providers. Provider organizations may create Accountable Care Organizations (ACOs) which incentivize coordinated, HVC through shared savings programs. Health plans and plan sponsors may use curated networks to ensure patients are receiving care only from high-performing providers. Regardless of the approach, directing care to high-value providers and practices can reduce unnecessary procedures and promote appropriate, cost-effective care.

In addition to having a choice in who manages their care, patients also benefit from having a choice in how and where they receive care. As previously highlighted, digital health solutions have emerged as a leading strategy to improve personalization and availability of care. Specifically, virtual care options have been highly impactful at making MSK care more accessible, convenient, and affordable for patients. However, patients still value the option for in-person care options when necessary.

Hybrid care: Research supports the importance of both virtual and in-person care options that meet individual patient preference and evolving needs. Hybrid care combines the benefits of in-person and virtual care into a single integrated solution, ensuring a cohesive experience for the patient.

In addition to improved care for patients, establishing a UCM for MSK care offers benefits for all stakeholder groups involved.