Musculoskeletal (MSK) Benefits Analytics, Inc. was created by professionals with experience in consulting, medicine, physical therapy, healthcare, and human resources.

 

We help finance leadership, heads of benefits, management trustees, and their advisors understand how MSK care is delivered and paid for as they steward health plan resources.

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MSKBA analyzes the historical claims data a plan sponsor obtains from its administrator. First, we assess whether the file includes the years and service-level detail needed for the AWS-programmed analysis. We then establish a plan-specific baseline of MSK utilization, care pathways, and spending. The report distinguishes data-supported findings from questions that require further review.

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MSK conditions affect people across age groups, and their prevalence varies with age and diagnosis. For a plan sponsor, national estimates provide context; the plan’s own claims show its participants’ experience. MSKBA also provides baseline and ongoing measurement in support of MyWay MSK, a related MSK solutions company.

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What an MSKBA analysis is designed to do

1. Establish a baseline. Analyze the available historical MSK claims by diagnosis, joint or body region, service, provider, and direct MSK cost borne by plan and participants copay and deductible liability.

2. Map care pathways. Show where participants enter care, which services follow, and where repeat utilization and spending accumulate.

3. Examine trends. Compare periods and population groups, including age groups, when the data is complete and comparable enough to support those comparisons.

4. Identify questions for review. Highlight patterns in diagnostics, procedures, therapy, or other services that warrant closer clinical or plan-management examination. Claims patterns alone do not determine whether an individual service was appropriate.

5. Support decisions and measurement. Present findings and options for benefit, access, or vendor review, then use comparable later claims to measure changes.

The sponsor receives a report explaining the analysis, its findings, and the limits of the data provided. MSKBA can also be retained for periodic reporting so decision-makers can monitor MSK utilization and spending over time.

To discuss your plan’s MSK claims data or request a sample analysis, please contact us.