In this episode of Relentless Health Value, host Stacey Richter talks with Dr. Jay Kimmel, an orthopedic surgeon and co-founder of Upswing Health, about the significant costs associated with musculoskeletal (MSK) injuries and conditions for self-insured employers and other plan sponsors.
They explore how a large portion of MSK-related expenses are for low-acuity injuries that often heal on their own without the need for emergency room visits or unnecessary treatments. Dr. Kimmel discusses the importance of addressing the 'white space'—the critical initial moments when a patient decides whether or not to seek emergency care.
He emphasizes the value of immediate access to knowledgeable professionals to help guide these decisions and prevent avoidable high-cost care. They also touch on historical practices where physicians would consult each other informally, suggesting that modern solutions like Upswing Health can replicate those beneficial spontaneous interactions to improve patient care and reduce costs.
=== LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/EP499
🔗 Visit Upswing Health: https://upswinghealth.com
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08:01 What is the "white space" in MSK spend?
10:43 Statistics on Connecticut's spending on plan members with low-acuity MSK injuries.
13:30 How back pain also easily transitions from a low-acuity issue to a high-acuity problem.
15:11 How plan sponsors can detect their white space downstream spend.
16:58 EP464 with Al Lewis.
17:02 EP470 with Nikki King, DHA.
18:15 Why where patients start their journey often dictates where they wind up and how costly that medical pathway is.
20:48 Where PCPs fit into this MSK spend issue.
25:26 EP468 with Matt McQuide.
25:34 EP471 with Christine Hale, MD, MBA.
25:39 Why access is key.
