Reverse inactivity and slash MSK costs with Move's 3:3 ROI

Validation Institute Certified Study Methodology demonstrates how Sword Health’s Move program improves health, lowers costs, and drives ROI for employers and health plans.

The results discussed in this study reflect the impact of the Sword Move program on physical activity engagement and behavior change within musculoskeletal care.

Key findings from certified Move analysis

• 1,663 per member savings: in annual MSK costs per participant. 
• 3.3x gross return on investment: with a maximum fee of $500 per member, this translates to a 3:1 gross ROI.

MSK costs are rising with more sedentary lifestyles

Musculoskeletal conditions account for one of the largest drivers of healthcare spending in the the US¹. For employers and health plans, the challenge is not only the cost of treatment after pain becomes severe. It is also the everyday inactivity that increases risk long before a claim appears.

Physical inactivity plays a major role in the rise of MSK conditions and related comorbidities.

• Today, 3 in 4 adults don’t get enough physical activity²
• Inactivity increases the risk of MSK conditions by 50%³ 
• 45% of people with an MSK condition also have a comorbidity⁴

That creates a clear opportunity for earlier support. When at-risk members build regular movement habits before pain escalates, employers and health plans can reduce avoidable MSK claims and downstream costs.

“This study is yet more proof that AI Care is transforming how care is delivered by providing high-quality personalized care that is also cost-effective, creating benefits for members, employers, and clinicians alike. By streamlining the decision-making process with AI, clinicians can spend more time with patients and engage at the human level, ensuring they receive the same high standard of care. It also enables us to extend the reach of our high-quality solutions to all patients, ensuring equitable benefits across the board.” – Virgilio Bento, founder and CEO of Sword Health.

Reverse inactivity trends to prevent avoidable MSK claims 

Reducing the volume and severity of MSK claims is a priority for benefits leaders, health plan administrators, and finance teams working to control rising healthcare costs.

Many MSK issues do not begin as major events. Back pain, knee pain, shoulder pain, and other physical complaints often start as mild discomfort. When early warning signs are ignored, they can progress into persistent pain, productivity loss, avoidable surgery, and other costly downstream interventions.

Regular movement can change that trajectory. Research shows that 1 in 3 musculoskeletal conditions can be prevented by regular exercise⁵. That is why proactive support matters. Helping members stay active before pain worsens can reduce both health risk and unnecessary cost. The early signs of MSK pain are often overlooked. But when left untreated, they escalate into chronic pain, productivity loss, unnecessary surgeries and other costly downstream medical intervention.

Sword Move is built to serve as this proactive MSK intervention.

What is Sword Move?

Move is Sword Health’s proactive movement program designed to help at-risk members build lasting physical activity habits.

The program makes it easier for members to stay active through short daily activities, step goals, and personalized guidance that fits into everyday life. By helping members move more consistently, Move supports earlier action before low-level pain or mobility issues progress into more serious physical problems.

Members receive:

• Convenient digital access through short daily sessions that fit into real schedules
• 1:1 expert guidance from a dedicated specialist who holds a Doctor of Physical Therapy degree
• Wearable-supported tracking that captures heart rate, steps, and active time to inform the program
• A habit-building approach designed to help members sustain movement over time

Study certifies Move’s proven results and 3.3x ROI

A comprehensive claims-based analysis involving 608 Move participants, matched against a robust control group, demonstrated substantial savings and a remarkable return on investment (ROI). 

The study methodology was independently validated by the Validation institute, an an unquestioned authority in vendor outcomes validation⁶.

While this research focuses on the Move program and its impact on physical activity engagement, the findings provide insight into a broader challenge in healthcare: helping individuals sustain healthier habits over time.

The engagement infrastructure behind Move was designed to address that challenge through continuous guidance and personalized support. That same infrastructure now underpins Pulse, which applies similar principles to cardiometabolic health.

How Move delivers lasting MSK savings

• $1,663 per member savings: in annual MSK costs per participant. 
• 3.3x ROI: with a maximum fee of $500 per member, this translates to a 3.3x gross ROI.
• Service savings per member: savings were realized across multiple healthcare categories:

Overall, for every dollar spent on Move, employers and health plans saved approximately $3.30.

Beyond the savings: better health outcomes at scale

Move also improved how members felt, moved, and engaged in their health. By helping members build sustainable movement habits, the program delivered measurable improvements in well-being across a large population.

Across 117 clients and over 26,000 enrolled members, Sword Move delivered:

• Strong clinical improvement: 91% of members felt moderately or much better⁷
• Increased physical activity: 69% of inactive and Insufficiently active members reached active or healthy active levels within 10 weeks and saw a 1 hr and 22 minute reduction in seated time per day⁸
• Significant pain reduction: 48% of members moved to pain-free, and of members with moderate or high pain the majority achieved clinically meaningful relief⁹
• Mental health improvements: Over half of the members with moderate to severe symptoms recovered to non-clinical levels¹⁰ of anxiety (60%) and depression (59%)¹¹
• Strong engagement at scale: Move is easy to implement across even the largest healthcare populations with over 300,000 sessions completed to date

These are not just logged activities. These are real outcomes. When people build regular physical activity habits, they feel better, need less care, and stay engaged in their health.

These findings illustrate how consistent, personalized support can influence health behaviors at scale. Sustained behavior change remains one of the most important drivers of long-term health outcomes and healthcare cost reduction.

What these findings mean for benefits leaders

For benefits leaders and health plan buyers, this study sharpens the most important evaluation question: can a program create the day-to-day behavior change required to improve outcomes over time?

Move suggests that the answer can be yes, but only when support shows up consistently, feels personal, and fits into daily life.

That matters beyond MSK. Many of today’s most costly conditions are shaped by the same underlying challenge. People often know they should move more, sleep better, eat differently, or manage stress more consistently. What they lack is support that appears often enough, adapts quickly enough, and remains relevant long enough to help those habits stick.

From Move to Pulse: expanding the behavior-change foundation

Since this study was conducted, the engagement model developed through Move has expanded into Pulse, Sword Health’s cardiometabolic AI Care program. Move showed that personalized guidance and continuous engagement can help people build healthier routines and maintain them over time.

Pulse builds on that same foundation and applies it to cardiometabolic health.

Instead of focusing mainly on physical activity, Pulse supports a broader set of daily habits that influence long-term health. That includes movement, nutrition, sleep, and stress management.

For employers and health plans, that matters because many of the most costly conditions are shaped by the same day-to-day behaviors. By extending the Move engagement model into these areas, Pulse is designed to support healthier habits across the cardiometabolic conditions that drive rising cost and risk.

Methodology overview

The analysis behind these findings used robust statistical methods to ensure reliability:

• Study Design: The study employed a retrospective cohort analysis on 608 Sword Move members and 608 controls that only received traditional care.
• Inclusion Criteria: To be included in the study, participants had to be 18 years old or older, have continuous enrollment for at least six months pre- and six months post-index date, and have an MSK condition. Participants in the Move group had to complete at least one Move session. Controls had to have at least one claim related to MSK and one of the following treatment events: traditional physical therapy evaluation or visit (PT), occupational therapy, chiropractor, or Office visit.
• Data Sources: Data was sourced from medical claims and medical benefit eligibility records, linked to Sword program data, spanning from July 2022 to February 2025. 
• Propensity Score Matching (PSM): PSM was used to create matched sets of treated and control subjects with similar baseline characteristics. This method helps ensure comparability between the two groups by balancing covariates that could influence outcomes. Participants and controls were matched based on a wide range of key covariates (age, gender, geographical state, baseline MSK, PT, surgery, and total costs, and related utilization, along with 13 comorbid diagnosis and spend categories). The matching used a glm distance and nearest neighbor matching within a predefined caliper, with exact matching on eligibility period and gender.
• Difference-in-Difference (DiD) Analysis: The DiD approach compared changes in medical costs between the treated and control groups before and after the intervention. This method accounts for time-related trends and external factors that could affect both groups, allowing for the isolation of the causal impact of the Move program. 
• Baseline Balance: A balance table was used to verify that the matched groups were statistically comparable across all covariates, with all absolute standardized mean differences below 0.1, ensuring that the measured savings can be attributed to the Move program.

Balance of key covariates in the matched groups