Forecast for Digital MSK in 2024

Virtual-Only MSK Offerings 

The last few years have seen an explosion of virtual-only digital health companies claiming to offer “full MSK solutions.”  While these companies have seen unprecedented funding, the actual solutions they offer have largely failed. Uptake is often less than 1% of eligible employees or members, and the measurement of return is often based on theoretical savings calculated using “intent to have surgery” as a ratio data comparison.  

The virtual-only solutions help solve steerage in some regards, but do not have any specialists to escalate to when the patient is not appropriate for physical therapy, nor when the patient is not improving as would be expected. These supposed “full MSK solutions” usually ignore post-operative care and are led by health coaches, not true licensed MSK specialists 

This is the year that one or two of these companies (Hinge and Sword) will likely try to go public – allowing the public to finally see behind the curtain. Kaia has nearly given up on the U.S. market, retreating to Germany where they have a stronghold and are thriving. Optum will likely become the majority or sole owner of the U.S. virtual-only market. Cigna has barely used Recovery One, and the Blues are becoming a bit disenfranchised with Hinge who is starting to look for provider partners. Sword is focusing on D2C models as well. For more information, contact Tim Hedke.

Employers Re-Evaluating Their Purchases 

Employer plans are re-evaluating the single-point point solutions they have purchased and are assessing if there is any true ROI. This year will be a bit of a reset, as current digital MSK providers will likely be pushed aside for alternative or more inclusive solutions. More well-rounded companies like Omada, are taking big steps with payers and employers as a multi-point solution, but still lack any real touch point with the specialist markets when conservative care management has failed. Once the patients get out of the digital world and into the “regular healthcare system” navigating to find a specialist is when the actual costs occur, and the proposed savings of these digital-only solutions are really exposed.  

The Digital Front Door 

Many companies in the space are focusing on transparent pricing– not by procedure code but by bundle of care. Companies like Ouch, Hatch and others are trying to steer patients into orthopedic practices. They market to digitally minded potential patients. Other in-network and value-based contract providers like Carrum and Nimble are focusing on steering patients to the right providers through care navigators. For more information, contact Tim Hedke.

Value-Based Care and Direct-to-Employer Solutions 

Value-based care and direct-to-employer self-funded care solutions are similar aimed at: 

  • reducing costs 
  • making costs more transparent 
  • increasing accessibility and quality of care 
  • focusing on member satisfaction and outcomes. 

These two models will become more prevalent with successful MSK practices. Digital physical therapy, brick and mortar physical therapy, care navigation, and orthopedic surgeons all play a role in this model and must work together for the true magic to happen. 


Retailers are jumping into offering MSK healthcare. Walmart, Amazon, and Dollar General are all looking to explore the space, with Costco partnering with a digital MSK solution for its members. Virtual-only orthopedic providers like Ortho Live or Moonlight Ortho are trying to carve themselves out to be a low-cost triage provider in the MSK space 

The MSK landscape will be dramatically different for everyone within the next 3-5 years.  For more information, contact Tim Hedke