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ActualHealth MSK ROI Calculator

Projected Annual MSK Financial Impact

Modeled savings based on pilot risk signals
ProjectedSavings
$0
ProgramCost
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NetSavings
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EstimatedROI
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Pilot-stage projection only. Based on modeled assumptions, not confirmed claims data.
Percent fields accept whole-number percentages. Example: enter 40 for 40%.

ROI Reference

Use this section to help interpret each calculator input and select assumptions that are conservative, realistic, or high-risk.

Total Members

Total Members represents the number of eligible individuals included in the ROI model. This may reflect a pilot population, worksite population, employer group, health plan cohort, or targeted member segment.

Population Size Common Use
50–100 members Small pilot or proof-of-concept group
100–500 members Employer group, onsite pilot, or targeted risk cohort
500–5,000+ members Larger employer, health plan segment, or expanded deployment

Pain Prevalence (%)

Pain Prevalence represents the percentage of members reporting musculoskeletal pain or discomfort. This helps estimate how much of the population may be relevant for MSK intervention, education, triage, or prevention.

Population Type Typical Pain Prevalence
General workforce 20–35%
Physically demanding workforce 35–55%
Self-identified pain population 50–75%+

Moderate / Severe Pain (%)

Moderate / Severe Pain represents the percentage of members with pain intensity high enough to suggest functional impact, increased utilization risk, or need for more active support.

Risk Level Typical Range
Lower-risk population 10–20%
Mixed commercial population 20–35%
Higher-risk MSK population 35–55%+

Multi-Region Pain (%)

Multi-Region Pain represents the percentage of members reporting pain in more than one body area. Multi-region pain may indicate higher complexity, higher functional burden, and greater likelihood of future utilization.

Population Type Typical Multi-Region Pain Range
General workforce 10–25%
Mixed MSK population 25–40%
Higher-risk pain population 40–60%+

Monthly Cost Per Member ($)

Monthly Cost Per Member represents the monthly program cost for each eligible member included in the model. This is treated as a per-member-per-month cost and annualized across the full population.

Pricing Model Typical Monthly Cost Per Member
Low-cost digital wellness add-on $0.50–$2.00
MSK digital prevention / engagement tool $2.00–$6.00
Higher-touch MSK support model $6.00–$15.00+

Event Cost ($)

Event Cost represents the estimated average cost of a meaningful MSK-related utilization event. This may include treatment, imaging, specialist care, emergency care, procedures, therapy episodes, workers compensation exposure, or productivity-related costs.

Event Type Typical Direct Cost
Minor PT / conservative care episode $500–$2,000
Imaging + specialist escalation $2,000–$6,000
ER + orthopedic escalation $5,000–$15,000
Surgery-related MSK episode $15,000–$50,000+
Workers comp + lost productivity case $10,000–$100,000+

Annual Event Rate (%)

Annual Event Rate is essentially the percentage of high-risk members expected to experience a meaningful MSK-related cost event within a year.

Population Type Typical Annual Event Rate
General healthy workforce 5–10%
Mixed commercial population 10–20%
Higher-risk MSK population 20–35%
Chronic pain / high-risk identified members 30–50%+

Examples of MSK-related events may include:

  • Physical therapy episode
  • Imaging such as MRI or X-ray
  • Specialist consult
  • Emergency room visit related to pain or injury
  • Pain-management utilization
  • Injection, procedure, or surgery escalation
  • Short-term disability episode

Reduction Rate (%)

Reduction Rate represents the expected percentage reduction in MSK-related events due to earlier identification, targeted engagement, personalized action planning, onsite support, or improved self-management.

Model Type Suggested Reduction Rate
Conservative model 5–10%
Realistic commercial model 10–20%
Strong engagement / onsite support model 20–30%
Aggressive high-impact model 30%+
Note: This ROI model is intended for planning, pilot evaluation, and business case development. Actual results should be validated against claims data, utilization data, employer-reported outcomes, or partner-provided program performance data when available.

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