It is clear that for the last 15 years the primary care physician has been proclaimed the ‘gatekeeper’ to healthcare in America. There have been billions of dollars invested over the last decade, in particular, in the consolidating of large primary care groups in order to drive margins, particularly in the Medicare Advantage space, and control the healthcare spend by attempting to change healthcare delivery. However, a new ‘reality’ is increasingly being acknowledged by the employers and payors whose healthcare plan members are those who are still working and on employer, or commercial, insurance plans. This reality is summarized by the following facts:

  • 27% of the total cost of care for commercial insurance is spent on MSK services

  • Myriad data and publications demonstrating the importance of a ‘PT-First’ strategy in dramatically reducing total MSK spend including

    • 30% reduction in imaging

    • Up to 68% reduction in surgeries

    • 70% reduction in ER visits for non-emergent MSK problems

  • 76% of employers rank MSK conditions as top 3 cost drivers

It is clear that the physical therapist is now poised to be the new ‘gatekeeper’ in the MSK space and the ‘key’ to developing an effective value-based MSK strategy to reduce the total cost of care. It is my belief, and the belief of Genie Health, that the role of the physical therapist in the MSK space will be one of rapid ascension as the value to the healthcare system that PT’s will bring to VBC strategies will be measurable and extremely impactful.

However, I also believe that there are several key challenges in developing a VBC strategy for MSK care that is scalable nationally. These challenges include (1) the ability standardized care pathways so outcomes can be measured and improved, (2) the ability to effectively leverage technology to address the shortage of physical therapists at a time when the capacity is less than the demand for their services, (3) the ability to reproducibly diagnosis movement problems virtually and customize rehabilitation solutions that focus on real improvements in total physical well-being. This last issue is the challenge I wish to focus on in this Editorial. I believe that a standardized algorithm for evaluating human movement that can be deployed virtually is a strategic ‘must’ for large-scale and nationwide virtual diagnosis of MSK disorders. I am going to highlight two of the thought leaders in the functional movement screen space, Lee Burton and Gray Cook, from FMS. They have a new App called

Symmio ( that enables therapists to deploy a virtual functional movement evaluation and deploy corrective exercises or rehabilitation to the individuals who are desiring to maximize their physical well-being. At Genie Health, partnering with thought leaders like Gray and Lee are central to our strategy and our position as the leading technology platform in VBC Healthcare Delivery in the MSK Space. Here’s the interview:

  • Q: Lee, why did you develop Symmio?

    A: FMS has known for many years we needed a more scalable and holistic solution to better address movement health. From data and experience, we were guided to look at lifestyle and behavioral factors, that when coupled with movement screening, could give a more complete picture of someone’s MSK health. The fusion of this holistic mindset and technological advances has allowed us to create a very simple and user-friendly platform.

  • Q: What makes it valuable to therapists?

    A: Symmio allows patients to self-assess the key contributors to overall MSK health and wellness and then report that data to the provider. Doing this prior to a visit can provide valuable insight into not only movement limitations but other lifestyle factors that may be contributing to their MSK problem. This process will provide awareness to both the clinician and patient of the importance of the lifestyle component.

  • Q: What problems do you feel Symmio can address in helping PT’s make virtual diagnosis for movement disorders?

    A: We are all getting less time with our patients so we must be creative in how we collect patient assessment data. By leveraging technology and empowering the patients we can facilitate and enhance the patient interaction. The clinician will now be armed with not only movement data but with additional valuable lifestyle information which will allow a much more targeted and efficient encounter. Even on discharge the providers can stay engaged through this platform and intervene prior to more significant problems arising.

  • Q: How about prescribing treatments?

    A: Symmio provides automated exercises and tips to specifically target the areas that were found to be most problematic. This programming, along with the clinician’s skill set on improving movement problems will most certainly enhance the patient experience and overall outcomes.

In conclusion, we believe that physical therapy will play an increasingly central role in the VBC Strategy to reduce the total cost of MSK healthcare spend. Genie Health is committed to partnering with technologies like Simio in order to fulfill our mandate to enable physical therapy providers to drive value in the healthcare marketplace and establish PT’s as the epicenter for triaging the vast majority of MSK healthcare delivery.