Relentless Health Value EP499: Self-insured Employers and Other Plan Sponsors Are Paying Millions for MSK (Musculoskeletal) Injuries That Would Have Healed Themselves, With Jay Kimmel, MD
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Feb 5, 2026 Jay Kimmel, MD, orthopedic surgeon and co-founder of Upswing Health, explains how routine MSK injuries often spiral into costly care. He discusses why most sprains and back complaints are low-acuity and how early specialist triage and rapid access can prevent unnecessary ER visits, imaging, and surgeries. The conversation highlights practical pathways to steer patients toward simple, effective care.
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MSK Is A Major, Largely Low-Acuity Cost Driver
- MSK (musculoskeletal) spend comprises ~20–30% of plan costs and rapidly accumulates from common low-acuity injuries.
- Many low-acuity MSK problems (about 80%) will heal without costly intervention, exposing large avoidable spend.
More Spending Doesn’t Mean Better Health
- Rising healthcare spend has not produced a matching 'health dividend' in outcomes despite more care.
- Increased utilization often reflects care delivered in the wrong place, by the wrong clinician, or at the wrong time.
The 'White Space' Fuels Costly Cascades
- The 'white space' is the moment patients self-triage after an MSK injury without expert input.
- When left alone, patients often choose high-cost, low-value pathways (ER/urgent care) that trigger cascade care.