Chamber Series Part 2: How You Can Support Your Team with the Rise of Health Care Costs: Medical Cost Savings Programs

We’re back with Part 2 in our cost saving series. | View Part 1 to learn more about pharmacy saving programs. 

As a recap, we know the upward trend of health care costs is expected to continue, impacting employers and individuals alike. High drug prices, increases in outpatient procedures, and more members needing high-cost care are challenging health plans, employers, patients, and the entire health care system. 

So how can you make sure your employees are being taken care of, and what is Excellus BlueCross BlueShield doing to help improve quality of care while combating these costs?

In this week’s post, we’re talking about increases in outpatient surgeries, especially on hips, knees and other musculoskeletal (MSK) conditions. These conditions are one of the leading drivers of health care expenses in the U.S. and consistently one of the top three highest costs for our health plan. In 2021, there was an estimated 9.5 million visits to the emergency department across the US for MSK conditions.(1) And, $800 million was spent by the health plan for MSK-related costs in 2021.(2) This continues to be a trend in 2024. In fact, the health plan has spent an additional $57 million on outpatient surgeries – including hip and knee surgeries – through the first five months of the year compared to the same time last year.

Costs aside, this can also have a big impact on businesses in the form of employee productivity: Nationwide, it has been found that musculoskeletal disorders account for an average of eight days away from work.(3)

So, what is being done to address this?

Many MSK conditions can be effectively managed or even improved with physical therapy (PT).(4) We analyzed our data and saw that in 2021-2022, adherence to PT was low. For example, of our members who were facing back pain and were prescribed physical therapy, 18% completed only one PT visit.(2)

We knew we needed to make it easier for our members to access and adhere to their PT plans to help improve their outcomes. That’s why we now offer digital musculoskeletal (back, neck and joint) health care and PT services with our plans through our partner, Vori Health.* Support from Vori Health can help:

• Increase physical therapy engagement, resulting in better quality of care.
• Increase ease and speed of access to care, resulting in better compliance with treatment.
• Reduce unnecessary invasive treatments and trips to the emergency room, resulting in lower overall costs.
• Reduce absenteeism, resulting in higher work productivity.

Plus, Vori Health can help your employees get back to their lives faster with access to:

• Convenient video visits.
• Medical evaluation and diagnosis.
• Personalized treatment including physical therapy and more.
• Non-opioid pain medication and imaging if needed.
• Support to help manage pain, regain strength, and enjoy life.

Even better, Vori Health visits are provided at no cost to members on many of our health plans (subject to deductible, where applicable). This service can be the first step in addressing MSK conditions to support traditional PT but does not replace your local Physical Therapist.

Actions you can take to help control costs:

1. Download our MSK Savings Toolkit where you can access more information on Vori Health and a prewritten email for sharing with your employees. This toolkit will support you in opening a dialogue with employees as well as sharing ways employees can navigate their MSK conditions, understand if virtual PT is right for them, and help improve outcomes.   
2. Please don’t hesitate to contact your account manager or broker for more information on this program.
3. For more helpful content to educate and engage your employees in their health care, visit ExcellusForBusiness.com.

Next in the series we explain what goes into premium costs to help you better explain it to your employees.

*Embedded for Fully Insured plans; Buy-up for Self-Funded groups.
1 Estimates of Emergency Department Visits in the United States, 2016-2021, Centers for Disease Control and Prevention [CDC].
2 Work-Related Musculoskeletal Disorders and Ergonomics, Centers for Disease Control and Prevention [CDC], 2019.
3 2021-2022 Health plan data
4 Musculoskeletal Pain: Current and Future Directions of Physical Therapy Practice - PMC (nih.gov)
Vori Health is an independent company that offers virtual musculoskeletal (back, neck and joint) health care and physical therapy services to Excellus BlueCross BlueShield members.