Duncan Sibson, Krish Maypole

Seeking care for an MSK injury can be overwhelming, costly, and downright frustrating. Our healthcare system can feel like a tangled mess, making it nearly impossible for patients to ensure they are receiving high quality care. At Icon Health, we guide members through the healthcare system, connecting them to the right provider, services and care at every step of the way. 

We ensure that members receive the most personalized and comprehensive care possible by engaging members and providers in-person and remotely across the care continuum. Many existing MSK solutions engage patients at specific points within the care continuum. As we’ve previously written, however, these narrow solutions leave too much room for people to fall through the cracks.  

Centers of excellence (COEs) are an existing solution meant to raise the quality of surgical care for people with MSK conditions. COEs are often hubs for talented surgeons, innovative techniques, and cutting-edge technologies. However, receiving care at a COE can be inconvenient and inefficient for some, requiring long-distance travel when the quality of care at local providers can be similar. COEs are incentivized to channel patients toward surgery, even if they don’t need it, as performing more procedures leads to more revenue. While rates of surgery for multiple procedures have increased in recent years, the outcomes are comparable with exercise therapy and sham surgeries, indicating that surgery may not have been the best route for some of these cases. For someone who does not actually need surgery, a COE alone is not the answer.  

On the other hand, digital physical therapy and home exercise programs have been praised as ways to decrease costs associated with MSK care, combat chronic pain, and close accessibility gaps. While virtual care for MSK conditions is a valuable part of the general care pathway, it still leaves people behind. Though they aim for accessibility, digital PT solutions actually have stringent inclusion criteria; for example, one study reveals a 51.2% rate of exclusion. These solutions typically do not accept patients who have had surgery within 3-6 months even though there’s merit to starting PT right after surgery. Some solutions have combined digital PT with access to in-person PT and/or wearable technologies, marketing themselves as complete solutions. That said, these solutions don’t cover the full continuum of care and are still only part of a complete solution.

In trying to establish a complete, integrated care team, it may seem that the solution lies in partnerships between COEs and digital physical therapy services, which together cover a broader part of the MSK care continuum. However, this partnership fails to include patients who need in-person non-surgical care, like evaluations, injections, or on-site physical therapy. These gaps in care not covered by existing solutions are how patients get left behind in the healthcare system. 

Icon’s comprehensive approach is the solution that leaves no one behind and increases patient satisfaction. Specialized care navigation promptly connects members to care they need, whether virtual or in-person. Icon uses evidence-based provider and facility matching techniques, optimizing for cost and member experience. In the process, we engage and support members as they travel through our tangled, messy healthcare system, from their very first visit, all the way until their pain is gone.