Top 5 Causes of Unnecessary MSK Surgeries – How Health Plans Can Respond How can health plans use upstream engagement, greenlighting, and PROMs to bend the cost curve? Check out our take in this week's newsletter.
Protera Health
医院和医疗保健
Many health plans struggle with rising MSK costs. We solve this through a virtual, multidisciplinary solution.
关于我们
Many health plans struggle to contain rising musculoskeletal (MSK) costs. Protera Health solves this with a virtual, physician-led, multidisciplinary solution. This leads to lower costs and better member health. "How is Protera different from all the other digital MSK solutions?" Three core features distinguish Protera from other solutions: 1 - Robust clinical model: the only digital solution that individualizes treatment and engagement, centered on patient reported outcome measures (PROMs). 2 - Friendly contracting: in-network billing that eliminates the need for administrative expenses or up-front costs for health plan partners 3 - Connection to in-person care when needed: we navigate patients to preferred provider networks to ensure high-quality care delivery when surgery is needed. How Protera Health started: Our founding team of orthopedic surgeons and clinical informaticists each had pioneered care transformation at our home organizations (health systems and managed care plans). We joined forces to transform specialty care through an affordable, accessible, and scalable virtual approach. When we started Protera Health, there was no shortage of digital MSK solutions on the market. But these solutions all were tech-first and clinical-second, designed to be wellness benefits and unable to meaningfully improve health outcomes. We knew there was a need for a clinical-first, robust solution that delivered multidisciplinary treatment and that resulted in positive lifestyle changes for our patients.
- 网站
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www.proterahealth.com
Protera Health的外部链接
- 所属行业
- 医院和医疗保健
- 规模
- 11-50 人
- 类型
- 私人持股
Protera Health员工
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Melvin Makhni, MD MBA
President and Co-Founder, Protera Health --- Chief of Spine Surgery at the Brigham and Women's Hospital, Harvard Medical School
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Rodrigo Jazinski
CTO & Coach <> Product, Engineering & Innovation | Engineering Leadership | AI & Automation
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Brenda Oakleaf, PT, DPT, GCS, CLWT, NBC-HWC
Physical Therapist, Remote Licensed in (Active): AK, AZ, CO, FL, ID, IN, MA, MI, MT, NC NV, OH, OR, SD, UT, VA, WA, WI, WV, WY (Inactive): IL, NE
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Eric Makhni MD MBA
We help health plans lower MSK costs while improving health and satisfaction outcomes.
动态
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We help health plans lower MSK costs while improving health and satisfaction outcomes.
My dad has had end-stage, bone-on-bone knee arthritis for over three years. No knee replacement. None on the horizon. He has some days that are worse than others, but he's totally fine. The secret? Well, he has two orthopedic surgeon sons who taught him that managing symptoms while preserving function can delay or even avoid surgery. Yet, most of our treatment options—whether in-person or digital—focus on short-term relief: PT, injections, or surgery. What’s missing? Lasting education and patient activation (more on activation in a future post). We tell patients, "You don’t need a knee replacement just because you have arthritis." But do we help them truly internalize that? Not everyone has orthopedic surgeons in the family. But my dad’s case proves something important: When education comes from trusted sources in a meaningful way, it changes behavior and healthcare decisions. When you look at cost-saving MSK innovation, especially from the perspective of health plan and employer purchasers, can you point out where the innovation drives lifestyle and behavior change? If not, chances are the benefits will be short-lived and simply window-dressing. That’s why, when designing our own digital MSK program, we kept coming back to one key question: How do we take our decades of clinical care and turn it into something we’d want to give to our friends, family, and loved ones? We’re not just treating symptoms—we’re changing behaviors. That is the only path to sustainable value creation via cost savings and health improvement. ?? If you're curious about how we’re redefining MSK care, check the link in my LinkedIn profile. PS - I cannot get over the chat-gpt image that I "created" for this post...
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Do you know who your costly MSK members are? Can you identify at-risk situations before they happen? We just made it a whole lot easiest. This week's newsletter features a FREE ICD CODE DOWNLOAD of the 5 costliest MSK conditions - back, neck, hip, knee, and shoulder. Over 1,100 codes, organized by category, hand-sorted by us (so that you don't have to!). ?? Use this list to: ? Pinpoint high-cost MSK claims ? Identify members for proactive interventions ? Optimize MSK management strategies What are you waiting for?!
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We help health plans lower MSK costs while improving health and satisfaction outcomes.
??If you are a health plan or system leader and have not heard about Geisinger’s lifetime guarantee for joint replacement, it’s time to pay attention... In 2018, Geisinger launched a truly groundbreaking initiative—offering a lifetime guarantee on joint replacements for members of the Geisinger Health Plan receiving a Medacta knee (going offscript: "groundbreaking" is a term that gets thrown around a lot but is fully justified in this context). This program now extends to primary and revision total knee, hip, and even shoulder replacements. I first learned about this from the one and only Michael Suk, MD, JD, MPH, MBA, FACS, FACHE, and the implications are massive. Why this is a game-changer for all stakeholders: ?? For Patients: Confidence that their hospital and surgeon stand behind their surgery for life Financial security—unexpected costs are covered No more comparing plan benefits—stick with Geisinger and stay covered ?? For Providers (Hospitals & Surgeons): Zero-cost marketing—the guarantee itself attracts patients Operational efficiency—standardizing around a select set of implants saves time and money ?? For Health Plans: Member retention built-in—a lifetime guarantee means patients are far less likely to switch plans Competitive differentiation—this is a true market advantage True provider alignment—better incentives for quality care delivery ??? For Implant Manufacturers: Stronger partnerships with top hospitals and health systems Market validation—if a hospital is willing to back an implant for life, it’s a powerful endorsement Key questions for health plan & health system leaders: ?? Most hospitals already limit vendors for high-frequency surgeries—could your system replicate this model? If not, are you using the right implants? Or is it a matter of getting surgeon buy-in? ??How much do you spend on member retention & marketing? Would a lifetime guarantee be more cost-effective? ??As a health plan, do you trust your provider partners enough to offer a lifetime guarantee? If not, how are you improving quality to get that point? If so, how are you creating win-win initiatives for you both? Are there any other plan/provider partnerships out there that are similar to the Geisinger joint replacement guarantee? (There are many I am not aware of...I'll be on the hunt and report back...) Risant Health ps - image created (after a lot of headache) with chatgpt. I know it's missing the fibula and that the implant design is not correct (unless those sidebars are the collaterals...). Had to settle for this one after way, way too many attempts.
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We help health plans lower MSK costs while improving health and satisfaction outcomes.
The Origin of Protera Health When I started clinical practice in 2016, we implemented PROMs for research—but quickly realized their power in improving decision-making and outcomes. Scaling PROMs across our health system led to clinical transformation, a NEJM Catalyst publication, and opportunities to present our work via grand rounds at top institutions like Lahey Clinic, Northwestern Medicine, Mass General Brigham, Intermountain Health, Mount Sinai Health System, and others. A common question kept coming up: How can other health systems implement PROMs without wasting money (and time) reinventing the wheel? From Idea to Reality In 2021, we launched Protera Health to help hospitals and health systems implement EMR-based PROM collection for value-based care, just like we did at Henry Ford Health. Our first partnership with SSM Health was a success—but through customer discovery (which I thankfully learned about from my classmate Blake Hall), we learned that most hospitals and health systems weren’t incentivized to adopt PROM-based quality initiatives in fee-for-service models. Thankfully, we were only selling wireframes at the time. So, instead of building a product no one wanted, we pivoted to where the value was clear: risk-bearing entities like health plans and employers. We shifted from enterprise PROMs to individual applications, evolving our model from coaching to multidisciplinary care teams. Rather than automating the front-end care, we built tech to streamline operations—enrollment, scheduling, content, and revenue cycle. This kept our human component intact, which has been a driving force in our clinical and cost-savings outcomes, not to mention our NPS of >80. Today, Protera Health helps health plans and health system employers drive better outcomes and lower costs through PROM-based care transformation. We're just getting started, and we're looking forward to sharing our experience with you all along the way. #ValueBasedCare #DigitalHealth #MSKCare #Entrepreneurship #ProteraHealth
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??Breaking News: Virtual MSK Care Outperforms In-Person Treatment! Traditional multidisciplinary care has been the go-to solution for treating musculoskeletal (MSK) conditions—but what if virtual care could do it better? At Protera Health, we put our virtual multidisciplinary MSK program to the test, comparing its outcomes to those of traditional in-person care. The results? Stronger improvements in pain relief, physical function, and mental health—all with higher patient engagement and lower costs. ??Key Findings: ? 4.6-point improvement in physical health scores vs. 2.4 in traditional care ? 2.8-point mental health improvement, exceeding in-person results ? Surgical-grade improvements in pain interference, anxiety, and depression ? 9.4/10 patient satisfaction and an NPS of 81 What does this mean for health plans? Better outcomes at a lower cost, increased engagement, and a more scalable way to improve member health. ?? Get all the details in our latest newsletter below! Or you can watch the full breakdown in our latest video. Link in the comments! #DigitalHealth #VirtualCare #MSKCare #HealthcareInnovation #MedicareAdvantage #ProteraHealth #ValueBasedCare
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Engaging Medicare Advantage members in digital health isn’t easy. Without the right approach, programs struggle to drive meaningful participation, leading to higher costs, lower adherence, and missed opportunities for better outcomes. At Protera Health, we’ve cracked the code! ?? In our latest LinkedIn Newsletter, we break down the five essential strategies that make a difference: ? Human-first care teams, not just AI ? Multi-channel engagement beyond telehealth ? Data-driven motivation to boost adherence ? Web portals over mobile apps for accessibility ? Family involvement to drive participation ?? If you're in Medicare Advantage, digital health, or patient engagement, this is a must-see! ?? Read the newsletter below. Want to watch the full video? Link in the comments! What engagement strategies have worked for your health plan? Let’s discuss in the comments! ?? #MedicareAdvantage #DigitalHealth #PatientEngagement #HealthcareInnovation #ProteraHealth
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?? 30% of MSK surgeries are unnecessary. What’s the solution? Virtual, clinical-first care. Health plans are spending millions on avoidable procedures, imaging, and ER visits—but tech-driven solutions alone aren’t enough to curb rising MSK costs. In this video, Eric Makhni MD MBA, our CEO and Co-Founder and value-based care expert, shares how Protera Health’s virtual, clinician-led approach is transforming MSK care by: ? Focusing on the 20% of members driving 80% of costs ? Providing real clinical care—not just AI-powered coaching ? Measuring actual health outcomes, not just app logins ? Delivering scalable, virtual care that improves patient health ?? Enjoy the highlights in this week's newsletter, or watch the full video on YouTube to learn how health plans can cut MSK costs while improving outcomes. Link in the comments! Let’s rethink MSK care. What strategies are you using to reduce unnecessary treatments? Drop your thoughts in the comments! ?? #MSKCare #HealthcareCosts #ValueBasedCare #DigitalHealth #ProteraHealth #HealthPlans
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?? 30% of MSK surgeries are unnecessary. What’s the solution? Virtual, clinical-first care. Health plans are spending millions on avoidable procedures, imaging, and ER visits—but tech-driven solutions alone aren’t enough to curb rising MSK costs. In this video, Eric Makhni MD MBA, our CEO and Co-Founder and value-based care expert, shares how Protera Health’s virtual, clinician-led approach is transforming MSK care by: ? Focusing on the 20% of members driving 80% of costs ? Providing real clinical care—not just AI-powered coaching ? Measuring actual health outcomes, not just app logins ? Delivering scalable, virtual care that improves patient health ?? Enjoy the highlights in this week's newsletter, or watch the full video on YouTube to learn how health plans can cut MSK costs while improving outcomes. Link in the comments! Let’s rethink MSK care. What strategies are you using to reduce unnecessary treatments? Drop your thoughts in the comments! ?? #MSKCare #HealthcareCosts #ValueBasedCare #DigitalHealth #ProteraHealth #HealthPlans