Validating Virtual Physical Therapy: Demonstrating its Impact on MSK Care

Somatic offers an agile, versatile, and value-based platform that provides immediate access to virtual physical therapy care for musculoskeletal (MSK) conditions. A recent study published in the American Journal of Managed Care estimated the economic benefit of patient-initiated virtual physical therapy (PT) services. The study concluded that health plans providing individuals the opportunity to initiate virtual PT will see significant savings in MSK care costs. See Study

MSK conditions were already a big burden on the healthcare system surpassing both diabetes and cardiovascular diseases. During the COVID-19 pandemic, we saw a significant shift in the daily routine of the working population further increasing the trend toward a sedentary lifestyle. Physical therapy is a quite effective and safe option to treat MSK problems. Although medication or surgery requires a diagnosis from a physician, patients can have direct access to PT and receive a clinical diagnosis and treatment plan directly from the PT. Furthermore, the Affordable Care Act has a mandate that requires healthcare plans to cover PT within certain categories such as preventive care, chronic disease management, and rehabilitation care. Studies have shown that patients who have directly sought PT help themselves had fewer PT visits, lower healthcare costs, and better outcomes compared to patients who were referred to PTs by physicians. However, limited PT availability, transportation, out-of-pocket costs, and physician referral requirements for government insurance coverage are the main obstacles for patients to seek physical therapy help themselves.

While there is data to suggest that virtual PT can lower PT costs, the associated cost savings and ease of tracking outcomes through a technology platform like Somatic Engage are extremely beneficial. Virtual PT is better suited to value-based care contracts than traditional in-practice physical therapy. The study concluded that patient-initiated virtual PT changes the landscape of MSK care and pain management, offering a high potential ROI in terms of clinical and economic value. The mean medical care savings per person per year from virtual PT ranged between $1,116 and $1,523. The study demonstrates that the benefits of virtual PT result in a reduction of 6.6 hours of pain-related missed work per person per year.

The study concluded that savings are due to several key factors:

1. Virtual PT is easier to access than face-to-face PT services, making it easier for patients to start treatment early. For patients with low back pain, immediate access to PT can lower medical costs across the board for advanced imaging, inpatient services, emergency services, injections or surgery, and pain medication. Earlier access to PT is associated with a 22% reduction in 1-year medical costs related to a patient's MSK condition.
2. Virtual PT increases adherence to PT-prescribed protocols, promoting continuity of care, improving attendance, and ensuring follow-through with evidence-based treatment guidelines. Adherence to treatment guidelines is associated with 54% lower costs for PT care.
3. Virtual PT is less costly than in-clinic PT, due to lower overhead cost, increased accessibility, reduced need for referrals because of direct access, and scalability.

This is the first study to estimate the value of patient-initiated virtual PT at the population level. The study results conclude that if priced correctly, patient-initiated virtual PT will increase the value of MSK care with an ROI between 2.0 and 2.5 among the general working population, and the break-even price is around $1,000 for the care plan. Changing the first contact of MSK care to the virtual platform could help improve the value of care delivery and lead to a paradigm shift in the delivery system, empowering individuals to manage their health.