Impact on Medical & Pharmaceutical Spend and Utilization

WEA Trust and Kiio partnered to offer innovative digital musculoskeletal (MSK) care to support members with low back pain. A large, claims data, cost-consequence analysis demonstrated that Kiio participants had 62% lower medical and pharmaceutical spend, avoided unnecessary treatments, used 89% fewer opioids, and benefited from improved clinical outcomes.

WEA Trust Profile

110,000 members
Low Back Pain
WEA Trust is an independent, not-for-profit health insurance company that provides group health insurance and administrative services to public employers – state, county, and municipal groups – throughout Wisconsin. WEA Trust’s mission is to improve member health and experience by providing high quality and affordable care. Known for its forward-looking vision and innovation, WEA Trust complements traditional care networks with a suite of curated Enhanced Care Solutions to offer members convenient, accessible, evidence-based healthcare options.

Study Overview

The Problem
Low back pain (LBP) has been a substantial and consistent driver of medical utilization and cost for WEA Trust. It is also a significant concern for WEA Trust’s employer groups given its impact on employment costs and productivity. WEA Trust partnered with Kiio to proactively intervene with easy, convenient, and evidence-based digital musculoskeletal (MSK) therapy care for medically appropriate members struggling with back pain.
The Solution
Kiio, white-labeled to WEA Trust,  launched in January 2018 and is offered to all members regardless of LBP claims history. Health plan members enroll on a completely voluntary basis.
Prior to enrolling, interested members complete Kiio’s online screening to gather baselines and confirm medical appropriateness. Members who are ineligible to participate for medical or other reasons are directed to appropriate in-network care as part of Kiio’s customized Care Path Optimization(SM). Eligible members are provided immediate access to Kiio’s digital MSK care program, which includes three progressive levels of therapeutic exercise specific to the member’s type of LBP, pain education, virtual coaching, and unlimited access to 1:1 Care Team support.
Study Methodology
In this study, WEA Trust and Kiio collaborated to quantify Kiio’s impact on member outcomes, medical and pharmacy utilization, and cost of care. The large, longitudinal study compared a year’s worth of claims from Kiio participants (N=656) to a control group receiving traditional MSK care for LBP (N=23,709). For Kiio participants, 12 months of claims were assessed after their enrollment date in Kiio, and for those receiving traditional care, 12 months of claims were assessed starting with their first LBP claim. All data was then normalized to member months.

Total Medical & Pharmacy Spend

Kiio participants had a 62% lower combined medical and pharmacy spend as compared to the traditional care group (p < 0.05). This is the fourth claims study examining Kiio’s impact on medical and pharmaceutical claims related to chronic MSK pain, and these results are in line with the previous three studies.

Medical Utilization & Spend

The study results demonstrated statistically significant lower medical spend for low back pain services of 62% in Year 1 for Kiio participants than the traditional care group (p < 0.05), with lower utilization of urgent care services, diagnostics, and procedures.
Medical Utilization
(% Lower in Kiio Group)
ER/Urgent Care/Ambulance
Advanced Imaging (MRI, CT)
Radiology (X-Ray, Ultrasound, Nuclear Medicine)
Office Visits/Consults
“Our main objective is always to improve member health and experience. This is exactly what we are seeing with Kiio, while also dramatically lowering medical costs.”
- Mary Hughes, WEA Trust Vice President of Medical Affairs

Prescription Medication Utilization & Spend

The claims analysis found a significant savings of 81% in LBP-related pharmacy spend for Kiio participants (p < 0.05), with dramatically lower days’ supply of medications, including 89% lower use of opioids and 74% lower use of benzodiazepines.

Mental Well-Being

Given the clearly established link between chronic pain and mental health, the study also evaluated pharmaceutical utilization of antidepressants. Kiio participants had 51% lower antidepressant use than WEA Trust members with a LBP diagnosis who did not participate in Kiio (p < 0.05).

“With COVID compounding mental health challenges and causing members to delay appointments, the impact of Kiio’s effective pain management on not only physical but also mental wellbeing is critical. With Kiio, we’ve been able to help members reduce pain and improve quality of life while lowering employer partners’ costs.”

- Tim Bartholow, MD, WEA Trust Vice President and Chief Medical Officer

Clinical Impact

Members participating in Kiio saw reduced pain and better function. Based on self-reported survey data collected in-app, 89% of members reported a decrease in pain and 76% reported improved function. The average decrease in pain in Kiio participants was 48% and improvement performing daily tasks was 46%.*
*Based on pain reduction from baseline using NRS pain scale and functional improvement from baseline using PSFS scale, which tracks member-perceived level of difficulty performing a functional activity that the member identifies as personally relevant and negatively impacted by pain.

Member Experience

Kiio members reported being highly satisfied. They remarked that Kiio helped them to feel better quickly and keep their pain away. They valued Kiio’s ease of use, 24/7 access to care, convenience, guided structure, and that the program does not require special equipment or appointments.
“Kiio was extremely accessible, easy to understand and use. It motivated me to do my exercises regularly. I’ve benefitted in more ways than just lower back pain relief. It’s helped me sleep through the night.”
“The program kept me on track. I liked having a complete set of exercises laid out and designed for me and the app to guide me through it. The illustrations, the details in directions, the reminders, and being able to see my progress – it was like having a personal coach.”
“It was so convenient to use just my phone. The program is simple, structured and short. Being able to do exercises at home and on my own schedule kept me committed.”
“Kiio’s easily accessible solution is customized to each member’s individual needs. Our members like the flexibility and that they’re in the driver’s seat. Our team likes Kiio’s evidence-based approach and how Kiio integrates clinical practice guidelines with technology to tailor therapeutic exercise, monitor improvement, provide coaching, and report on progress.”
- Lisa Harlow, MS, CES, WEA Trust Director of Member Health Services

Moving Forward Together

Based on these positive and sustained results with Kiio for low back pain, WEA Trust was the first partner to roll out Kiio’s expanded offering to all of its members. WEA Trust members can now use Kiio to not only improve back pain but also to manage and prevent knee, neck, and hip pain.
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