The value of virtual physical therapy for musculoskeletal care.

Objectives: To estimate the economic benefit of evidence-based patient-initiated virtual physical therapy (PIVPT) service among a nationally representative sample of commercially insured patients with musculoskeletal (MSK) conditions.

Study Design: Counterfactual simulation.

Methods: Using a nationally representative sample from the 2018 Medical Expenditure Panel Survey, we simulated the direct medical care savings and indirect cost savings from reduced absenteeism resulting from PIVPT among commercially insured working adults with self-reported MSK conditions. Model parameters of the impact of PIVPT are drawn from peer-reviewed literature. Four potential benefits of PIVPT are explored: (1) more rapid access to PT, (2) improved adherence to PT, (3) less expensive PT care per episode, and (4) reduced/avoided referral costs of PT.

Results: The mean medical care savings per person per year from PIVPT range between $1116 and $1523. Savings are mainly attributed to early initiation of PT (35%) and lower cost of PT (33%). The benefits of PIVPT result in a mean reduction of 6.6 hours in pain-related missed work per person per year. The return on investment of PIVPT is 2.0 (medical savings only) or 2.2 (medical savings plus reduced absenteeism).

Conclusions: PIVPT service provides added value to MSK care by facilitating earlier access and better adherence to PT and lowering the cost of PT.