January 13, 2026
Fully-insured plans
3.7x ROI by reducing surgeries for fully insured plans
Musculoskeletal (MSK) conditions remain one of the most expensive and volatile drivers of claims for fully insured health plans. Despite significant investment in traditional physical therapy and utilization management, it’s clear that MSK surgery rates continue to drain health plan budgets.
This whitepaper presents a claims-based analysis of Thrive’s impact on MSK spend in fully insured plans. Using the highest industry standards of matched cohorts and difference-in-differences methodology, the study evaluates how shifting care away from high-cost surgical pathways affects utilization and total cost.³
Download the full whitepaper to learn how Thrive’s expert-guided, home-based AI Care delivers a 3.7x ROI within a single plan year for fully insured member populations.³
3.7x
Gross ROI per-member-per-year (PMPY)
$2,934
MSK spend reduction (PMPY)
81
Fewer surgeries per 1,000 members
$2,267
Surgery reduction savings (PMPY)
What this whitepaper helps you evaluate
Whether reducing avoidable MSK surgeries can deliver defensible, near-term ROI for fully insured plans without increasing clinical, financial, or operational risk.
Key learnings inside the whitepaper
- Why reduced surgical utilization is the primary driver of MSK savings in fully insured plans²
- How changes in downstream utilization contribute to predictable, within plan-year ROI
- What member outcomes and engagement data indicate about adherence and durability⁴
- How to interpret these results within the constraints of fully-insured plan design and risk exposure
Contributors to White Paper

Exploring the breakthroughs behind AI Care
Footnotes
United States Bone and Joint Initiative. The burden of musculoskeletal diseases in the United States (BMUS). 3rd ed. 2014.
Dieleman JL, Cao J, Chapin A, et al. U.S. health care spending by payer and health condition, 1996–2016. JAMA. 2020;323(9):863–884. doi:10.1001/jama.2020.0734.
Thrive’s ROI methodology uses retrospective claims analysis with propensity score matching and difference-in-differences, consistent with standard observational health economics practices.
Sword Health has published over 40 peer-reviewed studies and independently-validated claims analyses using real-world evidence to demonstrate improvements in pain, function, engagement, and productivity outcomes associated with Sword AI Care programs https://swordhealth.com/resources/clinical-studies