Most MSK vendors report on outcomes. Almost none can show the savings in your medical claims, at a scale your actuarial and finance teams can underwrite. Using a propensity score matched, difference-in-differences design across more than 59,000 matched commercial members, this study quantifies what happens to MSK spend, surgical utilization, and downstream cost when AI Care redirects the default pathway. The savings are visible in medical claims, the methodology holds up to scrutiny, and the sample is large enough to inform population-level benefit decisions.

What this report covers

Skipping physical therapy or conservative care doesn't make the cost go away. It tends to resurface later as surgery and the downstream utilization that comes with it.

In claims data, that redirection shows up as $1,950 PMPY in surgery savings and consistent reductions across every MSK service category.²

Key learnings inside

• Surgical avoidance drives the return. 72 fewer encounters per 1,000 members. $1,950 PMPY in surgery savings alone.²
• Savings appear across the full pathway - rehab, office visits, imaging, and ER, not just one category.²
• ROI has climbed each time it has been measured: 2.5x in 2022, 3.2x in 2024, 3.7x in 2025, and 4.0x in 2026.²
• Engagement is the mechanism. Members averaged 20.1 completed sessions, with 64% done outside business hours.²
• Members who started AI-led MSK care initiated opioids up to 57% less often over 12 months than those who began with in-person PT.³

About this report

This study was commissioned by Sword Health. Using propensity score matching and a difference-in-differences framework, the analysis compared 29,545 Thrive participants against 29,545 statistically equivalent controls drawn from a national commercial claims dataset of approximately 30 million lives across six years. All 62 balance measures met the accepted threshold for causal inference after matching. The methodology is consistent with Sword Health's prior commercial and Medicare Advantage ROI studies.

See what these results mean for your population.

Talk to a Sword specialist and model the potential impact for your specific member base and cost trajectory.