Can Virtual Joint Health Really Lower Cost & Improve Outcomes? Highmark's Data Says Yes.

Let's be honest: time is a precious commodity. It's often hard for people to be consistent with their physical care (2–3 times per week for 6–8 weeks) to effectively treat musculoskeletal conditions. At Highmark Health , we’re obsessed with improving access, outcomes and experience for our members – and our collaboration with Sword Health is enabling us to do just that.  

Virtual Joint Health

Virtual Joint Health powered by Sword Health provides members convenient, on-demand access to musculoskeletal care. Highmark members receive a personalized treatment plan guided by licensed physical therapists, utilizing a tablet with computer vision to guide movement and provide real-time feedback. The program addresses a range of musculoskeletal conditions affecting major joints and includes a preventive program for low-acuity musculoskeletal issues.

A Data-Driven Look at Cost Savings and Utilization

We dug deep into the data. Through a 12-month evaluation of Virtual Joint Health, we aimed to determine if participation in the program reduced health care costs and utilization compared to a control group of eligible but unenrolled members. A propensity score matched difference-in-differences (DID) analysis was employed to control for confounding variables.

Our evaluation, comparing 1,755 members using Virtual Joint Health (intervention group) to a similar group who didn’t (control group), yielded compelling results:

• Significant Cost Reduction: Compared to the control group, the intervention group experienced a substantial $112 per member per month (PMPM) reduction in overall health care costs. This decrease was particularly notable in musculoskeletal-related areas like surgery, imaging, physical care and chiropractic care. Compared to the control group, the intervention group experienced substantially larger decreases in musculoskeletal-treatable surgery costs ($1,010) and physical care costs ($144) over 12 months.
• Lower Utilization: During the 12 month evaluation period the intervention group had significantly lower emergency department visits (saving more than 100 ED visits) and in-person specialist visits (saving ~4 specialist visits per member) compared to the control group. Lower utilization—fewer ED visits, specialist consults, and hospital admissions—benefits both patients and the system's long-term sustainability.

Improving Outcomes and Experience

Our recent member survey and analysis of self-reported data within the Sword Health app reveal compelling evidence of the positive impact of Virtual Joint Health on member outcomes and engagement. These results demonstrate significant improvements in pain management, reduced surgical intent, and increased overall well-being—all contributing to an improved member experience and engagement.

• Improved Health Outcomes: Sixty-nine percent of participants with significant pain found relief with Virtual Joint Health. In fact, members reported a near 35% reduction in surgery intent. For members experiencing work or productivity impairment, we saw an improvement of over 26%. For those who completed at least 9 Virtual Joint Health sessions, their PHQ-9 scores decreased by an average of 18%. GAD-7 scores decreased by an average of 25%. This is what really makes a difference in the lives of our members.
• High Member Engagement: We also saw a remarkable 92% engagement rate (for those active at least 4 weeks), with 72% completing the program (at least 9 sessions over 8 weeks). Eighty-eight percent found the solution easy to use. That's not just adherence; it's adoption.

Looking Ahead: Expanding Access and Impact

This is the Quintuple Aim in action. Through these assessments, we’ve observed remarkable improvements in health outcomes, engagement, cost and utilization. The savings realized from healthier members are reinvested back into delivering that remarkable health experience, so it’s continuously easier for members to engage in care and manage health proactively.

Building on the positive impacts of Virtual Joint Health, Highmark has expanded access to Sword's virtual care for pelvic health. Nearly 1 in 3 women experience bladder issues, chronic pelvic pain, pelvic floor disorders or symptoms associated with intimacy well-being, pregnancy, post-partum and menopause. This new virtual care solution demonstrates Highmark’s dedication to enabling innovative, accessible and effective care for members.

Learn more in the announcement we shared at #ViVE25.