Chronic musculoskeletal pain is one of the largest demand streams in American healthcare — and one of the leakiest. Scroll to follow a thousand patients through the system you think you run.
Health systems think of themselves as the front door for musculoskeletal care. The patients, quietly and in enormous numbers, disagree.
Back, knee, hip, shoulder. The chronic conditions Medicare's ACCESS Model targets affect more than two-thirds of people with Medicare.
The rest start at Google, urgent care, a friend's advice — or the emergency department, at $1,389 a visit.
Out-of-network PT, competitor groups, freestanding imaging. The average hospital loses 10–30% of revenue to leakage.
No event fires. No alert triggers. A patient simply doesn't come back — and the continuity, the outcome, and the dollars go with them. At 10–30% of revenue, that's $200–500M a year for an average system.
For a decade the answer was to buy more doors. In July 2026, Medicare built one — and pays for what walks through it.
Patients enroll upstream in MSK Access — a digital-first Medicare benefit for chronic MSK pain, at no cost to eligible patients.
PT-backed protocols and a virtual care coach manage the months-long pattern the ED was never built for — measured by validated patient-reported outcomes.
Escalations route to partners. Imaging, injections, surgery — warm handoffs into the partner system, with co-management payments to the clinicians who share the care.
MSK Access is live for Medicare patients and growing nationwide. Health systems and orthopedic practices that partner become the escalation destination — with co-management revenue attached.
