Closing the Gap in Health Care Benefits for Chronic Pain


By Dr. Jeff Krauss, Chief Medical Officer, Hinge Health

Chronic joint and back pain is one of the main reasons employees call in sick. It afflicts employees in every type or work, whether they’re sitting at desks or lifting heavy objects. And it costs employers lost workdays, lower productivity, and medical expenses on surgeries, opioid dependency, and depression and anxiety.

Annual health care costs for chronic back and joint pain hit $380 billion in 2016, according to the Institute for Health Metrics and Evaluation. And both employees and managers are aware of its impact.

Ninety percent of surveyed employees say people who experience chronic physical pain are more likely to be anxious and depressed, according to a Harvard Business Review Analytic Services survey report, “The Future of Digital Care: Tackling the Costs of Physical and Emotional Pain in the Workplace.” While 81% of those surveyed say employers could do more to help people with chronic pain, one in three feels the topic is taboo at work.

These findings highlight a gap in health care benefits that could help employees prevent and resolve chronic pain. There’s an information gap, too: 81% of managers in the survey said it’s hard to know when their employees are in chronic pain and that they often find out only when employees miss work.

Unfortunately, traditional methods of treating chronic back and joint pain are often expensive and ineffective, involving opioid prescriptions or injections, and even surgeries that can carry price tags of up to $150,000 (although studies have demonstrated that surgery is not the most effective way to treat the pain).

The Challenge of Lifestyle Changes

Best practice research highlighting the complexity of chronic pain suggests that a more holistic approach addressing lifestyle changes, as well as diet, mental health, stress, and exercise, is more effective. This lifestyle-medicine approach is how I treat my patients as a physician.

But lifestyle changes are behaviorally complex. According to the report, “the most striking development in our knowledge about how to deal with back pain and other pain is understanding the importance of physiological and social factors,” says Dr. Daniel Cherkin, senior investigator emeritus at Kaiser Permanente Washington Health Research Institute.

Patients who receive mind-body therapies along with their regular medical care had less pain, better physical functionality, and improved mental health compared to those who did not get those therapies, according to a study Cherkin published in JAMA in 2016. Quitting smoking, losing weight, improving nutrition, and other behavioral changes also reduced chronic back and joint pain, according to a 2015 BMC Musculoskeletal Disorders study.

Virtual Care, Real Results

How can employers fill this gap in health care benefits for their employees with a more holistic digital approach to chronic back and joint pain?

US Foods, a food service distributor with $28 billion in annual revenue, partnered with Hinge Health’s Digital Musculoskeletal Clinic to offer a virtual option pairing physical therapy with behavioral health coaches, clinicians, and advanced wearable technology. This program’s more holistic care is free to participants and does not require copays or deductibles.

The company made the Digital Musculoskeletal Clinic available to members by mailing employees free tablet computers and such supportive equipment as yoga mats and exercise bands, all at no out-of-pocket cost to participants. By allowing employees to do their exercise therapy at home, using an app and wearable sensor technology, and pairing them with a full virtual clinical team, including dedicated physical therapists, health coaches, and physicians, US Foods helped its employees reduce weight and stress—and ultimately resolve their chronic pain.

For participating employees, US Foods’ medical claims declined by 50% for back and neck pain and 55% for musculoskeletal surgery, compared with employees who did not participate. Participants also reported having less pain, increased range of motion, improved strength, less depression and anxiety, better sleep, less need for medication, and fewer absences.

Taking Virtual Care to the Next Level

The report found that while many employers offer basic virtual care options, such as virtual doctor visits and mental-health counseling, less than half of the responding employees indicated they were aware of available, next-generation digital health care, such as apps and wearable technology. The gap was the largest for physical therapy: 60% of respondents said their employers offer in-person physical therapy, but only 15% indicated they have access to virtual physical therapy options.

Clearly, more employers could and should provide next-level digital care options for chronic physical pain that drive better outcomes at lower costs. Hinge Health’s Digital Musculoskeletal Clinic, which pairs advanced wearable technology with a comprehensive clinical care team, including doctors of physical therapy, physicians, and board-certified health coaches, is already available to millions of employees at Boeing, Salesforce, and US Foods. Learning more may help your organization grow by eliminating chronic health costs—and helping your employees lead better lives.

Download the Harvard Business Review Analytic Services report “The Future of Digital Care: Tackling the Costs of Physical and Emotional Pain in the Workplace.

Dr. Jeff Krauss, chief medical officer at Hinge Health, is a clinical assistant professor at Stanford University’s Department of Orthopedics and a part-time staff physician at the VA Palo Alto Health Care System.

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