A guided approach to musculoskeletal condition care improves health outcomes and lowers costs

Cigna Healthcare, the health and benefits division of The Cigna Group, has launched a new offering in collaboration with Hinge Health to expand access to digital musculoskeletal (MSK) care. The new partnership enables employers to offer Hinge Health’s platform combining exercise therapy, real-time exercise guidance, a wearable pain relief device, and support from licensed physical therapists and board-certified health coaches as a complement to the Cigna Pathwell Bone & Joint program.

More than half of American adults suffer from MSK issues, and more than 100 million workdays are lost annually due to these conditions. They are the leading cause of chronic pain and of disability and greatly impact quality of life and work performance. As such, these conditions are costly for American employers.

“Musculoskeletal conditions are a major health issue for employees and employers, as managing these conditions and the costs of treatment have been long-term challenges,” said Dr. Dan Noble, national medical director of orthopedic surgery and spinal disorders at Cigna Healthcare. “A more guided and customized approach to musculoskeletal condition care can have a significant impact on health outcomes and lower costs.”

This guided approach is central to Cigna Pathwell Bone & Joint, Cigna Healthcare’s enhanced condition-specific care program designed to help people easily navigate through the most appropriate and efficient treatment plan for their specific MSK condition throughout their treatment journey. The program uses advanced data and clinical expertise to develop a guided, personalized digital experience that connects customers to designated quality, cost-effective providers who help them better manage their MSK conditions, alongside surgery and travel benefits, if needed — which makes a tremendous difference in health and financial outcomes for both the employee and the employer.

When Cigna Pathwell Bone & Joint is paired with Hinge Health’s digital exercise therapy program, employees get a customized digital exercise care plan to manage their MSK pain. For employers, this additional level of support can result in additional cost savings in medical and drug spend, while making quality MSK services more accessible and equitable.

We sat down with Dr. Noble to better understand the workplace issues around MSK conditions and how the Cigna Pathwell Bone & Joint and Hinge Health programs can benefit employers and their employees.

What should employers know about the impact MSK conditions have on their business?

MSK issues can affect many types of businesses, not just the ones involving physical labor and repetitive physical tasks such as manufacturing and construction. People who work in jobs where they must stand all day, like retail or food services, or sit all day behind a desk or a computer are also prone to develop joint or back pain and other MSK conditions.  This can ultimately lead to chronic conditions which can impact both work performance and enjoyment of day-to-day life.

More than half of adults have an MSK condition, which can have a significant impact on employer costs. Research from Evernorth shows that these conditions accounted for $420 billion in health care spending each year.

MSK conditions can be excruciating, and they are the most frequent reason people are absent from work. In addition to the costs employers face due to absenteeism, lost productivity can also be an issue when chronic pain affects an employee’s ability to work.

What drives the high costs of MSK care?

MSK conditions are expensive to manage for several reasons. Many acute or chronic conditions result in surgery. Some acute trauma conditions, such as fractures and crushing injuries, require urgent care. Rare, autoimmune conditions such as rheumatoid arthritis, lupus or ankylosing spondylitis are often managed by specialty drugs. One in six people struggle to make informed decisions as they navigate their MSK condition, and that confusion paired with a fragmented care system often creates a disjointed, expensive care experience. Overtreatment, such as avoidable surgery, expensive imaging and ineffective injections, also drives up costs. Lastly, behavioral conditions are common with MSK conditions, as people grapple with new physical limitations.

How does the Cigna Pathwell Bone & Joint program help employers and employees?

Cigna Pathwell Bone & Joint aims to help people with an MSK condition of the spine, shoulder, hip, or knee get on the right treatment path, reduce unnecessary surgeries, improve outcomes,  and reduce employer spend. The program uses data and analytics to identify the most appropriate individualized plan based on the employee’s specific condition and evidence-based clinical guidelines.

Advanced predictive analytics models help detect people who are at risk of preventable MSK conditions so they can get the support they need early, before those conditions become more painful and more expensive to treat. The care plans are designed to guide people to the care that will provide the most long-term value in improving their health and workplace productivity, including physical therapy, chiropractic treatment, and pain management support. In some cases, the plan may involve opioid prevention and management. Surgery is considered only when necessary.

Cigna Pathwell Bone & Joint provides each employee with streamlined digital-first clinical navigation supported by a dedicated Clinical Care Advocate, who is a licensed nurse or physical therapist. The Clinical Care Advocate works one-on-one with the employee to develop a personalized care plan, which includes screening for behavioral health issues and lifestyle management concerns, leveraging existing benefits to ensure people have the support they need. As part of this process, the care advocate helps them understand their treatment and provider options available through their medical benefits, guides them through the care plan, and offers care guidance and support every step of the way to keep them motivated and engaged. Employees also have access to a personalized digital experience where they can learn more about their specific condition and treatment and complete assessments and other personalized activities that support their care plan. This results in a powerful approach to customer care that combines clinical expertise, coordinated support, and intuitive digital tools to empower employees to take charge of their health.

If surgery is the optimal treatment path for an employee, Cigna Pathwell Bone & Joint provides a benefit allowing engaged employees to receive care from designated, in-network surgeons with track records of delivering quality, affordable MSK care, at $0 surgical cost share from admission to discharge. (Note that for Cigna Healthcare non-HSA plans, the plan pays 100% of eligible expenses. For HSA plans, the plan pays 100% after the deductible is met.) Employers benefit from surgery costs that are up to 25% off average market rates for covered surgeries from admission through discharge with a Cigna Pathwell Bone & Joint designated provider, lower total cost of care, and increased employee productivity.

How does Hinge Health’s digital exercise therapy program help employers manage costs and help employees better manage their MSK symptoms from injuries or general wear and tear, as well as during pre-and post-surgery?

Hinge Health is a digital care platform that combines advanced technology with the expertise of a clinical care team who specializes in MSK conditions and will develop an exercise therapy program personalized to each individual’s needs. For many people suffering from MSK conditions, the pain can be acute from a specific injury or chronic, which means symptom management is ongoing. 

Conservative treatment plays an important role in effectively managing MSK pain, but there are barriers to treatment such as cost, time or geographic location. A digital exercise therapy program, powered by Hinge Health, can help overcome these barriers and make it easy for employees to access digital exercise therapy through a user-friendly experience so that employees can manage their symptoms wherever they are. A dedicated virtual physical therapist and health coach guide members through their recovery plans, delivering a personalized approach. Hinge Health members have reported a 68% average improvement in pain and a 58% decrease in depression and anxiety after 12 weeks.

Cigna Pathwell Bone & Joint, when integrated with Hinge Health’s digital exercise therapy program, is one more way Cigna Healthcare delivers value to our clients by expanding care options, addressing employee health challenges to improve clinical outcomes, increasing workforce productivity, and lowering total medical costs.