Workplace musculoskeletal injuries are among the most challenging cases to manage and account for the largest share of medical spend in workers’ compensation for employers and plan sponsors. They also make up a substantial portion of overall claim volume, with wide variations in both cost and outcomes.
Through a fully integrated solution, Paradigm delivers financial certainty, guaranteed maximum functional outcomes, and improved patient engagement.
spent on MSK injuries per year in
workers’ compensation1
Because of unnecessary surgeries, fee-for-service payment models, and other challenges, these cases create significant medical, indemnity, and admin costs.
Late identification of problem cases and a lack of outcomes accountability lead to an unpredictable recovery and uncontrolled care costs.
In these cases, care is often uncoordinated, whole-person data visibility is limited, and patient engagement is lacking. That means these cases lack the continuity and visibility to achieve optimal outcomes.
From back injuries on job sites to repetitive strain in long-haul drives, musculoskeletal claims are the number one cost driver in construction and commercial transportation. These injuries are a critical segment of claims with high variability and unpredictability, with significant fluctuations in both financial and recovery outcomes.
Through a value-based, risk-bearing model, HEROSM MSK addresses recovery management and surgical interventions for all musculoskeletal injuries. A single accountable team combines clinical management and behavioral health with real-time insights to identify risk early, avoid unnecessary utilization, and deliver maximum functional outcomes with financial certainty.
Proactive care that reduces risk
We identify barriers early and provide personalized support that prevents complications and avoids unnecessary utilization.
A network built for excellence
Curated MSK specialist network aligned to one model to reduce fragmentation, ensure consistency, and deliver accountable outcomes.
Data that drives faster recovery
We leverage real-time insights to guide adherence, optimize care, and drive a successful return to functional outcome.
Accountability from start to finish
We guarantee one accountable partner managing your musculoskeletal cost, quality, and outcomes until final RRTW or MMI, while easing workload and freeing bandwidth from your adjusters.
HERO MSK uses Paradigm’s curated network of top orthopedic specialists and ambulatory surgery centers, ensuring access to the right providers for the full range of musculoskeletal injuries, conditions, and disorders.
94.6%
patient engagement in care management5
(industry avg. 13-30%)
<6%
attorney representation5
(industry avg. 35-40%)
90%
return-to-work in less than
6-months after surgery5
(industry avg. 55-62%)
2x
functional improvement over clinical benchmarks (QuickDASH)5
(industry avg. 8-13 points)
Sources:
1 OSHA
2 Beaudoin, C., et al. Continuity of Physiotherapy Care and Duration of Compensation for Workers with Low Back Pain. PLOS One (2024).
3 Bouras, A., et al. Healthcare Utilization Fragmentation and Total Costs: Evidence from Administrative Data. MedRxiv reprint (2025).
4 Workers Compensation Research Institute (WCRI). Patient-Reported Outcomes in Workers’ Compensation. Cambridge, MA: WCRI, 2023.
5 Paradigm HERO MSK shoulder recovery customer data 2024-2025
