Musculoskeletal issues, otherwise known as MSK issues, account for something like 20% of the cost to any given health plan or employer or anyone else who is paying the bill for health care. That’s like one in every five dollars, which is meaningful when you consider million-dollar drugs and diabetes and all the other things that a purchaser of health care can write checks for. MSK is a big cost kahuna.
In this health care podcast, I talk with Chad Gray, who is the CEO of IMC, Integrated Musculoskeletal Care. Interestingly, Chad says that the problem with MSK in this country isn’t a cost problem usually. It’s a quality problem. It’s a problem of patients getting a whole lot of care that doesn’t actually relieve their symptoms or underlying condition.
This is what MSK care and the 4-minute mile have in common besides the blindingly obvious necessity of healthy bones to run fast. Everybody thought it was impossible for a human to run a 4-minute mile—until somebody did. And once that happened, it was like a dam opened and lots of people began breaking that previously impossible time. It’s conventional wisdom that MSK problems are mostly going to turn into intractable chronic conditions that ultimately result in surgery, which still doesn’t, in many cases, cure the symptoms or underlying problem.
Chad Gray and his team over at IMC may have broken the 4-minute mile when it comes to inventing a systemic approach to MSK care that actually works. Prepare for the dam to burst.
You can learn more at imcpt.com.
Chad Gray, MS, PT, Cert MDT, is cofounder and CEO of Integrated Musculoskeletal Care, Inc (IMC), providing outcomes-accountable musculoskeletal care programs that improve overall health care quality, reduce costs, and improve patient and employee safety. He has over two decades of experience as a clinical practitioner and is a widely recognized entrepreneur, health-benefit design consultant, and concierge practitioner focused on innovations in musculoskeletal triage, health care, and self-care.
02:23 How big is musculoskeletal care in terms of health spend?
03:20 One out of three patients are seeking health care for musculoskeletal issues.
03:52 EP244 with Lee Lewis.
05:13 “We don’t really have a cost problem in this domain; … we have … a quality problem.”
05:30 The increasing populations of chronic condition categories.
08:19 How to perform precision diagnosis at the macro and micro level.
09:13 Creating a new standard of care.
09:48 Taking accurate diagnosis and scaling that into best practices.
10:43 Ensuring that everyone is diagnosing in the same way.
11:24 EP225 with Joe Selby.
13:50 What precision diagnostic tools look like to patients and clinicians.
16:17 Tracking data throughout the entire diagnosis and treatment process, including patient outcomes data.
17:03 Verifying and validating that patients are progressing better through IMC’s system.
19:20 The dramatic shift in quality and cost within this standardized care model.
20:43 “The single most common reason for an opioid prescription … is low-back pain.”
21:40 Why we are so behind on improving musculoskeletal care across the country.
23:50 Why there are such huge gaps in capability and understanding within musculoskeletal care.
24:38 “What’s broken? Why is it broken? How do we fix it? Once we fix it, what does it look like?”
27:06 IMC—Integrated Musculoskeletal Care—and the system they’ve developed to standardize musculoskeletal care and create precision diagnosis.
28:18 Identifying outliers.
28:40 IMC’s continuous feedback loop to show providers the quality metrics.
29:24 Preventing data pollution.
31:19 Connecting to employer-sponsored plans and other payer/provider organizations.