Every eight minutes, another unnecessary back surgery is performed in the U.S. healthcare system, amounting to over 200,000 inappropriate procedures and two billion dollars in Medicare waste, according to shocking new data from the Lown Institute. As healthcare costs are projected to rise eight to nine percent in 2025, this systematic overtreatment of musculoskeletal (MSK) conditions represents a crisis that employers and health plans can no longer ignore (Lown Institute Hospitals Index, 2024, Mayer, 2024).
"Without sweeping, industry-wide change and a prioritization of evidence-based care that puts members first, inappropriate, unnecessary MSK surgeries will continue to be a significant cost driver," according to Mary I. O'Connor, MD, FAAOS, FAOA, Chief Medical Officer and Co-Founder of Vori Health.
Overtreatment, or low-value care, wastes between $75.7-$101.2 billion annually (Shrank et al., 2019).
The Growing Crisis of Unnecessary MSK Procedures
The Lown Institute's groundbreaking report reveals a disturbing pattern of overtreatment that extends beyond Medicare waste. Even prestigious U.S. News Honor Roll hospitals showed overuse rates exceeding 30 percent for certain procedures. The investigation uncovered:
- Hospital-specific overuse rates ranging from less than one percent to more than 50 percent for spinal fusions and laminectomies
- Widespread geographic variations, with states like New Hampshire, Iowa, Massachusetts, and Pennsylvania showing overuse rates above 18 percent
- More than 3,000 physicians receiving a combined $64 million from device and drug companies for consulting, speaking fees, meals, and travel
The study identified a troubling pattern: many patients with routine low back pain—without leg pain, nerve compression, or structural problems—were receiving major spine surgeries like spinal fusions despite having no clear medical necessity for such invasive procedures. Even more concerning, researchers found that patients with common age-related spine fractures were often receiving surgical interventions when more conservative treatments would have been appropriate (Lown Institute Hospitals Index, 2024).
These unnecessary surgeries don't just impact the bottom line. Rather, they put members' lives at risk and often lead to prolonged disability leaves of absence and additional invasive procedures.
Physician-Led, Holistic Care: A Proven Solution
As the only physician-led solution in the market, Vori Health uniquely addresses the 40 percent of MSK conditions that are most complex and expensive to treat—cases that physical therapy-only solutions simply cannot handle. Our physician-led care teams ensure appropriate diagnosis, triage, and evidence-based treatment from the start, preventing members from cycling through fragmented care that often results in unnecessary surgery.
Our hybrid approach combines virtual and in-person care, meeting members where they are and driving up to three times higher engagement. This proven model delivers results we stand behind, as demonstrated by our recent analysis of commercial membership claims between 2023 and 2024 achieving:
- $3,906 average savings per member
- 3.71:1 program ROI validated by Milliman
- 71% improvement in pain
- 126% improvement in physical function
- 68% improvement in anxiety
- 63% improvement in depression
These impressive outcomes stem from our recognition that MSK conditions rarely exist in isolation. Our specialty physicians provide evidence-based care, leading a unified team of doctors of physical therapy (DPTs), registered dietitians (RDs), and health coaches who work together to treat the whole person. Through this holistic approach, we address the anxiety and depression that often accompany chronic pain, provide nutritional guidance to reduce inflammation, and deliver coaching support for lasting lifestyle changes. The result? Consistently better outcomes without unnecessary surgeries.
2025: A Critical Year for MSK Management
As the industry faces heightened scrutiny of MSK vendors and demands greater transparency in cost, quality, and outcomes data, the choice becomes clear. Traditional approaches to MSK care are failing patients, employers, and payers. Vori Health's physician-led, holistic care model delivers:
- Validated cost savings through reduced unnecessary procedures
- Improved patient outcomes across multiple health metrics
- Convenient hybrid care that drives engagement
- Up to 4X ROI validated by independent analysis
With unnecessary MSK surgeries costing two billion dollars in Medicare waste alone, health plans and employers have a clear choice: continue with status quo and watch costs spiral, or partner with Vori Health to achieve validated 4:1 ROI while protecting patients from unnecessary procedures.
Ready to transform your MSK spending in 2025? Contact us today to learn how Vori Health, the nation's only virtual-first non-operative Center for Excellence led by physicians, can deliver guaranteed savings for your member population.
References
- Lown Institute Hospitals Index, 2024: Unnecessary back surgeries cost Medicare up to $600 million annually. (n.d.). Lown Institute Hospital Index.
- Mayer, 2024: Mayer, K. (2024, August 22). Employers project 8%-9% rise in health care costs for 2025. SHRM.
- Shrank et al., 2019: Shrank, W. H., Rogstad, T. L., & Parekh, N. (2019). Waste in the US health care system. JAMA, 322(15), 1501.
