MSK conditions are among the most expensive drivers of healthcare spend in the U.S., and the challenge intensifies as Medicare Advantage populations age.¹ ² For many plans, surgery and downstream interventions remain a persistent source of cost and variability.

This whitepaper explores how those patterns can change, drawing on a claims-based analysis that has been independently reviewed by global healthcare consultancy, Milliman. Understand what happens when care shifts away from high-cost surgical pathways, and what that shift means for utilization, total spend, and ROI within a single plan year.³

What this whitepaper helps you evaluate

Whether reducing avoidable MSK surgeries can deliver defensible, near-term ROI for Medicare Advantage plans while supporting member outcomes and minimizing clinical and financial risk.

Key learnings inside the whitepaper

• Why reduced surgical utilization is a primary driver of MSK savings in Medicare Advantage populations
• How changes in downstream utilization lead to predictable, in-plan-year ROI
• Why engagement and completion rates among members aged 65+ indicate stronger adherence and durability
• How to interpret these findings in the context of Medicare Advantage benefit design and population risk