Benefits of value-based care for employers and health plans

When benefits leaders and health plan executives evaluate healthcare strategies, one question rises above the rest: what are we getting in return for what we spend?

Too often, under traditional fee-for-service models, the answer is disappointing. Dollars go out the door, but employees remain in pain, absenteeism climbs, and high-cost claims keep landing on the balance sheet.¹⁵

Value-based care changes that equation. By linking payment to measurable results, it creates a feedback loop of accountability: patients recover more fully, employers and payers control costs, and providers are rewarded for outcomes rather than activity. These benefits are not theoretical. They are backed by clinical and economic data from organizations already putting these principles into practice.

The benefits of value-based care are immense for employers

Healthcare is now the second-largest expense line for most employers, second only to payroll.¹⁶ Musculoskeletal (MSK) care is the single biggest driver of employer health costs, with annual U.S. spending exceeding $500 billion when combining medical and productivity losses.¹

Despite this investment, value is elusive. An estimated $90.9 billion is wasted every year on unnecessary imaging, surgeries, and other low-value interventions.² This disconnect between cost and outcome exposes the flaw in traditional reimbursement. Employers pay regardless of whether members get better. That’s why the value-based care model has become the model of choice for forward-thinking employers and health plans.

By tying payment to results, value-based care restores alignment between all stakeholders. It rewards the outcomes that matter most: recovery, prevention, and productivity.

Look for value-based MSK care providers to maximize ROI

MSK conditions are the ideal proving ground for value-based care. They are widespread, costly, and often interventions like surgeries, imaging, and specialist referrals can be avoided with value-focused preventive care. Up to 36% of MSK surgeries are unnecessary, according to clinical data from Sword's member base.²

Digital-first MSK programs demonstrate how a value-based framework can transform care delivery. They emphasize prevention, track measurable outcomes, and align costs directly to results. Sword Health provides the ideal example. Sword's operationalizes the principles of value-based care by connecting payments to measurable health outcomes. Our outcome-based pricing model ties 50% of fees to member recovery, meaning employers only pay when employees improve. Sword combines deep clinical expertise, proprietary AI technology, and FDA-listed medical devices to measure progress objectively.

Sword’s model makes value-based care predictable, measurable, and financially accountable.

Clinical benefits: healthier people and stronger outcomes

The most important benefit of value-based care is better member healthcare outcomes. By rewarding recovery instead of utilization, the model motivates providers to deliver the right care at the right time. Sword Health’s outcomes illustrate what happens when value-based care is applied to MSK programs:

• 69% of members complete care pain-free³
• 65% finish treatment with no functional disability³
• 55% avoid surgery altogether³
• 39% reduce or stop using pain medication³

The clinical impact extends beyond physical recovery. Chronic pain is deeply linked to mental health. Research shows digital MSK programs can reduce depression by 64%⁴ and anxiety by 50%⁵, helping employees not only move better but feel better.

Value-based care also advances health equity. Sword’s virtual-first model ensures access regardless of geography or clinic hours. 26% of Sword members live in high-SDI (socially disadvantaged) areas, yet outcomes remain consistent across race, income, and geography.⁶ This is how value-based care delivers measurable results for all employees (not just those with convenient access to in-person clinics).

Financial benefits: measurable savings for employers and plans

For employers and health plans, one of the strongest advantages of value-based care is cost control. Under outcome-based reimbursement, payment only occurs when members get better.

The savings are quantifiable:

• $3,177 average annual savings per member⁷
• Up to 4.4× ROI in high-risk populations using predictive engagement⁸
• $90.9 billion in low-value MSK spend avoided²
• $2,916 per-member annual productivity savings⁹

These results are not one-time wins. Because payment is tied to clinical milestones such as pain reduction, functional improvement, and surgery avoidance, value-based care transforms healthcare from a static cost into a performance-based investment.

Operational benefits: transparency, speed, and convenience

Operational efficiency is often overlooked, but it is one of the most tangible benefits of value-based care for HR and finance teams. Sword’s model is designed for transparency and accountability. Employers know exactly what they pay for, when they pay it, and why.

• Transparent billing: Sword’s outcome pricing is simple with 50% at activation, 50% only after outcomes are achieved.¹⁰
• Faster access: Members start care quickly, averaging 3.8 days to first PT contact and 6.3 days to begin treatment.¹¹
• Better adherence: Sword achieves an 81% completion rate, compared with 30–50% in traditional PT.¹²
• Flexible access: 42% of sessions occur outside business hours and 23% on weekends.¹³

For HR and finance teams, that means predictable budgets and demonstrable ROI. For employees, it means care that fits real life.

Benefits for providers: alignment and professional satisfaction

Value-based care also reshapes incentives for healthcare providers. Instead of chasing visits, clinicians are rewarded for achieving recovery. This reduces waste, duplication, and burnout while reinforcing purpose and clinical excellence. Instead of chasing faster turnover and trying to increase volume of output, healthcare providers are rewarded when they deliver healthcare outcomes. This puts a focus on quality of care and accountability on tracking and reporting on measurable results.

In MSK care, that means fewer unnecessary imaging orders, fewer avoidable surgeries, and more members reaching their goals. Clinicians report higher satisfaction when their work translates directly into measurable recovery.

Make benefits measurable with value-based care

The benefits of value-based care are not promises. They are proven through clinical outcomes, financial savings, and operational improvements that employers can measure in real time. Patients recover, providers are rewarded, and payers pay only for results.

Sword Health’s outcome pricing guarantees that alignment. For employers, it means every dollar spent delivers measurable value.

Stop paying for care that does not deliver. Set up a call with a Sword expert and see how outcome-based pricing transforms MSK care from a cost burden into a strategic advantage.