Clinical Efficacy of Telemedicine for Musculoskeletal Conditions in a Medicare Advantage Population.

Abstract

Introduction: Musculoskeletal (MSK) conditions are highly prevalent among the Medicare population, and telerehabilitation has been shown to be equivalent to traditional in-person physical therapy for many patients.

Method: We studied the clinical outcomes of 100 consecutive Medicare Advantage patients from one insurer treated with a virtual physician-led MSK care team model. Patients had to have completed at least three clinical video visits to be eligible for participation. We also recorded rates of image ordering and referrals for in-person services.

Results: The average age of our patients was 72 years with sex equally divided. Fifty-two percent of our patients presented with symptoms in their lower back. All patients had an initial evaluation with a physician or nurse practitioner (NP) and a physical therapist during the same video visit encounter. The average number of follow-up physical therapy visits was 7.6, and 14% had a follow-up visit with the physician or NP. Forty-six percent of patients saw a health coach and 15% a registered dietitian for concomitant concerns. Imaging studies were ordered in two patients and referrals for in-person services were made in three. With all care provided through a telemedicine platform, we found a high degree of pain improvement (83%, p < 0.001) and physical health improvement (84-86%) in our cohort.

Conclusion: Our experience with Medicare Advantage patients demonstrates that multidisciplinary physician-led care in the telemedicine setting is effective in improving pain and physical function in older patients with MSK conditions.