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Virtual physical therapy offered in-network to select Medicare Advantage customers

3 months ago 30
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Cigna will be offering a virtual physical therapy program for patients with  musculoskeletal conditions to a group of its Medicare Advantage members in North Mississippi, Virginia, and North Georgia.

The company that makes the virtual PT platform — Walnut Creek-based RecoveryOne — announced Monday that this will be offered as an in-network benefit. The announcement underscores how payers are adopting digital tools to manage conditions that previously required in-person visits in the hope of lowering costs and increase convenience for patients.

“Virtual physical therapy makes treatment available to all older adults, including those who live in rural areas. It eliminates the need to travel, allowing the therapy to occur when and where it is most convenient for the customer,” said Christine Leo, vice president of senior products at Cigna in an email. “We are hoping that this convenience increases adherence to treatment, leading to better results and customers living healthier, more vital lives.”

Cigna has had a relationship with RecoveryOne given its venture arm invested in the company back in January 2020. Employer customers of Cigna who have less than 500 employees also currently are able to use the RecoveryOne tool. The announcement comes at a time when there is growing evidence that virtual PT is effective.

In January 2022, Kinex Medical published a report that said 87% of surgeons believe telerehabilitation is the future when it comes to recovery from musculoskeletal conditions. Many companies play in the virtual PT world  including Kaia HealthLimber Health and Reflexion Health.

Aside from the convenience factor that can help to boost adherence on the part of patients, RecoveryOne’s platform also offers flexibility.

“RecoveryOne has a nice continuum of care for customers from initial to mid to final treatment led by a licensed therapist who prescribes and adjusts the plan as needed in order for customers to achieve the desired outcomes in the most clinically appropriate manner,” Leo said.

Virtual PT offers an array of benefits. Patients in rural settings can access care more easily. Flexibility of when to do the exercises helps fit into patients’ schedules. Further, virtual PT helps patients receive care even in the midst of a physical therapist shortage.

Additionally, virtual physical therapy platforms can address some current concerns, such as offering a viable method for monitoring patient recovery and offering a cost effective treatment.

“As TKA surgical volumes spike and the site of care continues its shift to outpatient settings, we’ll continue to see the need for telerehabilitation to grow,” said Mike Buckholdt, president of Kinex Medical in a Kinex press release. “Care providers need a way to monitor and manage their patients’ recovery journeys in a cost effective, clinically equivalent way. The new class of post-operative recovery devices empower providers, patients, and payers looking for new ways to deliver unparalleled quality and a stellar patient experience at a reduced cost.”

And RecoveryOne believes its virtual rehabilitation has achieved quality of care, improved patient experience, and lowered cost. According to the announcement from RecoveryOne, it has analyzed claims data from more than 350,000 members, and successfully reduced total medical cost by $751 per member per month for MSK-related diagnoses.  Further, the analysis found RecoveryOne reduced costs by nearly 77% for low back pain and 84% for rotator cuff tears.

In the United States, almost 75% of adults 65 and older are impacted by musculoskeletal diseases, from osteoarthritis in the spine to fall-related injuries to hip and knee issues. Public insurance, such as Medicare, spent over $45 billion between 1996 and 2016 on MSK issues with neck and low back pain alone, according to a report.

“Our solution covers the majority of MSK conditions from head to toe, and with experience that spans more than eight years of working with older populations,” said Mark Luck Olson, CEO of RecoveryOne in the announcement. “As such, the solution is uniquely qualified to address some of the most common and complex conditions including total joint procedures, fractures from falls and low back pain which is the most burdensome of all MSK conditions.”

Credit: Vitapix, Getty Images

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 Publicité par Adpathway