For Medicare Advantage members with similar MSK conditions, the path they take through care can make a dramatic difference in downstream cost. One path can lead to imaging, surgery, and post-acute care. Another can resolve the condition through guided, low-intensity care, with substantially lower MSK spend.
A 2026 savings study examined members engaged in a clinically guided MSK navigation program in the Atlanta Medicare Advantage market. Members were matched to non-engaged members based on demographics, diagnostic risk category, comorbidity burden, social risk, and prior cost intensity, then observed for six months.
Members on the self-care pathway had approximately 79% lower total MSK spend than matched controls, representing $211.56 less per member per month, while addressable surgical spend was 56% lower.
Insights include:
- PMPM tables and annualized utilization and savings views by pathway
- Confidence intervals for each reported outcome
- The matching model and post-match balance diagnostics
- Where the program placed engaged MSK members across conservative pathways
Complete the form to download the MSK savings study.