Musculoskeletal conditions drive employer health care spend

A healthy workplace is typically a productive one, so when a chronic disease strikes close to home, both employees and employers are affected.

Musculoskeletal (MSK) conditions affect the bones, muscles, joints and certain connective tissues. Some of the most common conditions include arthritis, tendonitis and carpal tunnel syndrome. Often accompanied by debilitating pain, MSK impacts 1 in 2 Americans and is the top contributor to employer health care costs.1

An analysis of UnitedHealthcare data on the 3 costliest chronic conditions found that:

  • MSK is the costliest condition for employers at $52 per member per month (PMPM)2
  • Women account for 54% of MSK spend2
  • 75% of those affected by MSK are Gen X and Baby Boomers,2 who make up the majority of today’s workforce3

Additionally, when combined with a metabolic condition, the average cost per claimant can be 4 times higher than those without a metabolic condition.2

The impact of MSK conditions on a workforce can be extensive and costly to employees and employers. In addition to the cost of managing the condition, the pain that comes with MSK disorders may lead to decreased productivity at work and an increased likelihood of depression and anxiety.3 In fact, for employers, that drop in productivity equates to an average of $3,105 in lost productivity annually per affected employee.4 It’s also worth noting that just 5% of employees were responsible for driving 85% of total MSK cost.4

The effects of MSK conditions are magnified in geographic areas where they’re most prevalent. For instance, AlabamaArkansasKentuckyMississippi and West Virginia have the highest rates of arthritis in adults in the U.S.5

Fortunately, there are strategies employers can adopt to help employees manage their condition while helping rein in health care costs:

  • Encourage a healthier lifestyle
  • Offer behavioral health support
  • Provide financial wellness benefits
  • Make care easier to access with digital tools
  • Work with a carrier that addresses the full MSK continuum of care needs

Encourage a healthy lifestyle

Some of the most common MSK conditions, such as carpal tunnel syndrome and arthritis, are often compounded by daily, repetitive actions like sitting for prolonged periods of time at a desk. In addition to ensuring their employees have what they need ergonomically at their workplace, they can also encourage healthy habits and behaviors through incentive programs.

Incentive programs are designed to help promote employee wellness and prioritize preventive care. In doing so, they may lower the risk of employees developing MSK conditions and/or minimize the impact once diagnosed. Reward programs can be an effective way to encourage healthier lifestyles. For instance, UnitedHealthcare Rewards offers cash rewards to employees enrolled in eligible plans who meet daily step goals, get an annual checkup and more. Improving one’s base-level of health may help reduce risk factors for many conditions, including MSK.

Offer behavioral health support

Because living with MSK pain may lead to increased depression and anxiety, supporting employees’ behavioral health can be just as critical as addressing the physical aspects of MSK conditions. Pain, and chronic pain in particular, may lead to sleep issues, a decreased ability to participate in activities and a lower quality of life — all which may contribute to a decline in mental health.

Employers can help by making behavioral health benefits a priority. Benefits like an Employee Assistance Program (EAP) can provide confidential assessments to help employees understand what level of support they need, at no cost. And virtual behavioral health visits — either by phone or video — mean employees have access to care wherever they may be.

Provide financial wellness benefits

Employees with MSK conditions may have to see specialists, undergo surgery and take expensive pain medications, which can create additional financial stress for them and their family.

Financial wellness benefits could help employees better manage those costs. These benefits are becoming more popular as employees seek guidance in managing their finances. In response, 65% of employers plan to increase their financial wellness programs in the near future.6 Financial wellness benefits may include educational tools that improve financial literacy and financial support for when unexpected life events or medical bills arise.

Digital tools help make it easier to access virtual care

Physical therapy often plays a large part in the treatment of MSK conditions, but regular appointments can be disruptive to an employee’s work or home life. Digital tools like Kaia* and Hinge Health* — 2 vendors available through UHC Hub* — offer support via downloadable apps. These digital tools can offer more convenient and personalized pain relief options.

Kaia tracks a person’s movements using AI technology to ensure they are doing each exercise correctly, providing real-time audio and video feedback for help along the way. That way, employees get a program tailored to their fitness, pain and mobility levels that helps them manage their MSK symptoms.

Similarly, Hinge Health focuses on mind, body and behavioral changes to help employees potentially avoid costly surgeries. By pairing physical therapists, health coaches and wearable digital devices, the app can deliver care anytime, anywhere.

Work with a carrier that addresses the full MSK continuum of care needs

To help deliver more efficient care for MSK conditions, and provide support to employees and their families, it’s important for employers to offer health care solutions that span the entire care continuum.

UnitedHealthcare defines that continuum as encompassing 4 stages that include:

  1. Early engagement relies on condition-specific education and virtual resources as a first line of treatment. Weight and nutrition management are a focus, as is access to chiropractic, physical and occupational therapy.
  2. Conservative care assists employees in finding the right care through the provider network and gives them transparency into treatment costs. Navigation and support are also a part of this stage, including guidance on getting second opinions.
  3. If any surgical procedures are needed, UnitedHealthcare encourages employees to utilize designated Centers of Excellence (COEs) to ensure they have access to proven quality care facilities and optimized savings. A focus is also on pre- and post-surgical counseling.
  4. In the maintenance stage, prescription coverage, payment accuracy and claim review can help employees manage the logistics of the ongoing management of their condition.

Internal data analysis supports the effectiveness of this approach, which has resulted in:7

  • $14,000 average inpatient operations savings
  • 37% fewer joint replacement complications
  • 31.5% fewer readmissions for replacement surgeries

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