After years of steady increases, employer health costs are projected to jump at one of the fastest rates in years. Some forecasts point to health care cost increases of up to 10 percent, with more employers shifting costs to employees (Mayer, 2025). For self-insured employers, this is a direct threat to margins, competitiveness, and your ability to invest in your workforce.
Meanwhile, musculoskeletal (MSK) conditions continue to be among the leading cost drivers in employer health plans; nearly 40% of adults experience MSK conditions (UnitedHealthcare, 2025). They also represent one of the least efficiently managed categories. The combination of high cases, fragmented care pathways, and inconsistent clinical decision-making creates rising spend with no guarantee of better outcomes for your employees.
The "avoidable surgery" problem
In most employer health plans, MSK care still runs on a fee-for-service model: more visits, more imaging, and more procedures that may not drive real results for patients. Surgery can become the default solution rather than the last resort.
Growing evidence suggests that a striking portion of these procedures are avoidable. Recent analyses show that up to 50% or more of some MSK-related surgeries are unnecessary, with one “low-value” back surgery occurring every eight minutes in the US (Lown Institute Hospital Index). These are often driven by overuse of procedures, poor adherence to clinical guidelines, and lack of conservative care before operating.
For your organization, every unnecessary surgery is effectively a “double tax.” You pay directly for the procedure and post-acute care, but you also absorb indirect costs: time away from work, slower return to productivity, and the toll that chronic pain and surgical recovery exact on engagement and morale. When MSK is managed poorly, it does not just show up in your stop-loss reports; it shows up in absenteeism, presenteeism, disability claims, and even turnover.
Three MSK trends shaping 2026
Now, new trends are shifting how employers and providers approach MSK care. Here are three of the most important to consider:
- Cost pressures are increasing quickly. Employers are dealing with inflation, wage pressure, and competitive pressure all at once. Health spend that grows faster than revenue is simply no longer sustainable. Benefits leaders are under pressure from CFOs to produce real, measurable return on investment as well.
- Digital and hybrid care models have matured. Today, integrated, physician-led, data-driven MSK platforms can manage the full spectrum of MSK care. Beginning with early triage and continuing to complex case reviews, these programs can combine virtual and in-person care; they represent value-based models that are both operational and scalable.
- Employee expectations have shifted permanently. Remote and hybrid work have changed how people think about access to care. More employees are drawn to convenient, mobile-first experiences, personalized support, and clear guidance. They are far less willing to navigate fragmented provider networks.
The key takeaway? Moving to a value-based, physician-led MSK model offers a credible path to better outcomes and more predictable spend.
How value-based MSK care works
For many employers, "value-based care" can sound abstract. But for MSK conditions, it is both well-defined and operational. Now, participation among commercial health plans is growing: it increased from 34.6% in 2022 to 39.2% in 2023 (AHIP, 2024), and continues to grow. Here are its benefits:
- Earlier, smarter risk identification. Rather than waiting for high-cost events to surface in claims data, value-based MSK programs like Vori Health use predictive analytics to identify members at risk of surgery, imaging overuse, or long-term disability. Once detected, at-risk employees can be directed to a physician-led MSK team as their first stop.
- Conservative-first, whole-person care. Care begins with a comprehensive evaluation by a board-certified specialty physician who can rule out red flags, order appropriate imaging only when necessary, and build a personalized plan that may include physical therapy, exercise, behavioral support, and nutrition counseling. This MD+PT model ensures that both the medical "why" and the functional "how" of pain are addressed together, helping employees avoid the operating room.
- Objective measurement and accountability. Because the model is value-based, outcomes are tracked and tied to performance. Programs monitor changes in pain, function, return to work, and downstream utilization. Independent validation of integrated MSK programs can drive higher ROI by preventing unnecessary procedures and resolving pain earlier in the care journey.
Why this matters for your workforce
The financial case for value-based MSK care is compelling, but the human case is even more important.
Employees dealing with persistent back or joint pain often describe a cycle of frustration: long waits for specialist appointments, confusing recommendations, rushed visits, and a sense of being pushed toward surgery. When your MSK strategy is built around a physician-led, integrated model, you are offering your people something different: a single trusted team, evidence-based care that prioritizes non-operative solutions, and flexible access that fits around work and family.
This kind of benefit builds trust. In a tight labor market, showing that you invest in smarter, safer, and more convenient care for something as common and debilitating as back and joint pain can be a real differentiator.
Your next step
When benefits leaders introduce physician-led MSK care, they're not just adding a vendor—they're building a strategic capability into their 2026 benefits narrative. Done well, this approach demonstrates to employees that their health is a priority while generating measurable cost savings and positioning your organization as an employer who genuinely cares.
Vori Health is the only nationwide specialty MSK practice led by board-certified physicians. Our hybrid virtual and in-person model combines physician oversight, integrated physical therapy, and whole-person support to address complex and otherwise expensive MSK cases.
The best way to understand how value-based MSK care works is to see it in action. Download our report to learn more, and connect with our team to discuss how Vori Health can help your organization and your employees.
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