Scaling Virtual Solutions to Improve Osteoarthritis Management

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By Dr. Randall Stafford and Amanda Rees, CEO and Co-founder of Bold

Impact and Prevalence of Osteoarthritis

Osteoarthritis is a leading cause of disability for adults in the U.S. Nearly 50% of those 65 years or older have reported doctor-diagnosed arthritis. Furthermore, reduced physical activity from osteoarthritis can increase the risk of developing or worsening other conditions that often co-occur with osteoarthritis, like depression and type 2 diabetes. Adults with arthritis are 2.5 times more likely to fall and suffer fall-related injuries compared with adults without arthritis. 

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For healthcare payers, the cost of osteoarthritis treatment shows up in hospital care, medications, and outpatient visits. Since older adults are living longer and there is no cure for osteoarthritis, healthcare organizations can manage growing care costs by increasing efforts to improve long-term quality of life and facilitate lifestyle changes that slow progression and reduce disability for individuals with osteoarthritis.

Evolution of Osteoarthritis Care

Conventional medical treatment of osteoarthritis includes prescribing medications for pain management, other anti-inflammatory therapies, surgery, and physical therapy. In fact, 32% of osteoarthritis-related spend is on medications for pain relief. Other interventions, like hyaluronic acid joint injections, are expensive and show inconsistent results, driving up outpatient spend without providing lasting pain relief.

Over the years, we have seen a positive evolution as osteoarthritis treatment has begun addressing whole-joint strategies rather than a narrow focus on the degenerating cartilage itself. However, the next evolution needed to improve osteoarthritis care will be personalized, whole-person, mind and body strategies that equip individuals to self-manage their osteoarthritis symptoms. This perspective also fully leverages the insight that osteoarthritis affects and is affected by numerous co-morbidities.

Self-management and lifestyle changes in diet, exercise, sleep, social networks, lower alcohol intake, and mental health can provide pain relief, improve quality of life, and reduce overall costs of treatment for osteoarthritis. The rise of digital health companies that provide services to enable these healthy lifestyle changes should make it easier than ever to support individuals with osteoarthritis. Through these technology-enabled tools, solutions can be increasingly accessible, effective, and maintainable.  These digital interventions can allow patients to engage at home, when most convenient for them, and alleviate over-burdened providers. 

Exercise as the First Step

Health plans and providers can begin improving care today by encouraging individuals with osteoarthritis to engage in appropriate physical activity programs.

The American College of Rheumatology guideline recommends non-aerobic physical activity to reduce pain and maintain physical function. Research demonstrates that regular physical activity is strongly and causally linked to improvements in knee osteoarthritis health outcomes. As a bonus, physical activity can also address depressive symptoms, which are frequently linked to chronic pain and osteoarthritis.

The vast majority of Medicare Advantage plans offer various ways of facilitating fitness as a covered benefit, and these benefits increasingly include digital fitness options for older adults. Access to digital exercise eliminates barriers for individuals who aren’t able or prefer not to go to the gym, and at-home fitness is a great first step towards whole-body care for osteoarthritis.

Clinical leaders at health plans and provider groups have a straightforward opportunity to improve engagement with existing benefits and realize the financial savings associated with a more physically active member base. In part, this reflects the historical lack of attention given to physical activity.

Spurring greater adoption of self-management and lifestyle changes, like exercise, for adults with osteoarthritis is a win for health care groups who want to prevent rising costs from injury and disability. It’s also a big win for individuals with osteoarthritis who seek to improve and maintain their quality of life as they age. 

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