NRG Physio Co

Musculoskeletal health conditions account for over 600B in annual spend nationwide and takes the number 1 or 2 spot in health spending for self insured employers either just ahead of or just behind chronic preventable disease. Current solutions operate on antiquated systems of physical therapy. Even new, highly valued, solutions use the same systems of basic physical therapy just on more advanced pieces of technology. They still fail to address root cause of pain and provide a temporary relief for its end user.  Our model for physical therapy views the root cause of pain through the lens of movement technique and body mechanics. We operated this model for 6 years direct to consumer where we had incredible results with our primary customer having already tried and failed traditional physical therapy, chiropractics, medications, injections, and sometimes surgeries. When treating direct to consumer we were a cash pay model working one on one with every client. An early commitment to evaluating every joint in the body regardless of pain location revealed patterns of restriction in the body that would not be seen by only focusing on painful areas. Over time we found that restoring one key area of the body back to symmetry first would create change in all the other joints without working directly on them. This would become the Keystone Reset which is our IP around physical evaluation and pave the way for pain relief in 1-2 visits with over 90% of our clients.

As we see it, all pain based diagnosis are either incorrect, incomplete, or both because they fail to identify and  address root causes of pain. Traditional physical therapy modulates the symptom of pain just like medications and injections modulate pain. PT just modulates the symptom of pain using movement. To truly address the root cause of pain, you have to address all joints that aren't working well. Including the joints that are not painful. The greatest mistake in physical therapy and the services provided is assuming that because it does not hurt means it is normal. Not true. In fact, its been our experience across thousands of patient encounters that most results are created by working on joints and muscles that don't hurt rather than focusing only on painful areas. Legally, this can not even happen in an insurance based clinic due to laws around diagnosis codes and reimbursement. At NRG, our system of evaluation provides a clear path to changing movement, and thus, changing pain. It is accurate, systematized, repeatable, and scalable. Since evaluation and diagnosis are what drives treatment plan and progression, having an accurate and complete diagnosis is the critical element in a correct and complete treatment plan. We then follow up our evaluations with systems and process for treatment that give us repeatable results. We never run out of creativity to help our clients and will do whatever it takes to help them get results. 

Because we have been able to create repeatable results using our framework, we were able to digitize this into both digital and virtual care pathways alongside out on-site or near site, in person, on one one care. Our digital platform is a conversational AI that delivers evaluation, functional diagnosis, and begins treatment by deliver video based treatments via SMS. This is both a root cause solution and our single call to action and lead gen tool inside of an organization. All internal marketing drives engagement to a single, simple, low threshold entry point. "Just text this number."

When someone engages digitally we can follow up immediately to make sure we get the user on the right product as quickly as possible. Maybe the right product is staying inside the conversational AI. Or it could be moving the user to NRG University which is a sone with you platform where we combine our e-learning format with coaching inside a slow motion analysis app. Or it could be in person with one of our DPT's. We find the best fit for the employee first, knowing that we can always scale the service up or back if we need to later. Creating access and affordability to the highest quality care is critical to reducing wasteful spending. By having a suite of inventory from digital all thew ay through in person, we can be sure to be accessible and meet the employee wherever they are at. 

Providing therapy has already been validated in reducing cost back to the self insured employer. But still, many users receive therapy without getting results and end up having surgery that they did not need. Research estimates up to 70% of outpatient surgeries are unnecessary. Our aim is drastically reduce surgical procedures and other high costs, non-solution based claims for pain conditions like PCP visits, speciality visits, prescriptions for pain, injections, and advanced imaging like CT, MRI, and x-ray. We do this through a few key things that other MSK solutions do not do: 

1. Incentivized MSK screening. Many employers incentivize biometrics screening (blood work) as a way for employees to decrease monthly health plan premiums. We can do the same for an MSK screen. In doing this we can get face time with people who have pain and are not currently taking action, recapture those with pain who are already out in the marketplace, as well as screen those without pain - but have all the movement predictors and joints based predictors that lead to pain conditions. We can engage painful conditions with rehab, and non-painful conditions with prevention plans. MSK gets us in front of the masses early and allows us to tailor solutions to help solve pain problems, collect data on surgical intent, and starting shifting the perspective of employees towards a new approach to physical health. It also gets us in front of people who are making the decision to have surgery based only on the fact that their deductible has been met. We will help employees gain new perspective, remove uncertainty, take back control, and build resilience in the bodies, minds, and lives. 

2. Internal marketing to the captive audience. Competitors base engagement for a new company on historical engagement with previous companies. They do not actively engage members. They sit back and wait for someone to "need" to service and opt in on their own. First, we already know who needs to be engaged because of the MSK screen. Second, we build targets for engagement and run internal marketing campaigns to stay top of mind and extremely relevant. From our background in direct to consumer, we understand how people think, how they make decisions, how they will find excuses to not make a decision, and all the myths and misconceptions they have for why something is not for them. We also recognize we are not fighting for attention of our end users from just other potential service providers. We are fighting for there attention from everything going on in their life, every social channel, and every other ad placed in from of them.  So we build intentional marketing message to address all the things that could be important to someone in our 4 pillars of physical health: Pain, Fitness, Nutrition, and Sleep and we create daily touch points through email, SMS, phone calls, voicemails, Social media posts, and the direct mail.  Higher engagement = higher savings to the employer and great impact in the lives of the employees. We have found that engaging people on all these topics draw in more engagement for different reason and one topics always leads to the others. All of these things are intimately connected to solving pain at its root cause and an added bonus - they are also the root cause solutions for chronic preventable diseases like cardiac disease and diabetes. We can collaborate on programs with direct primary care and further drive down wasteful health spending in other areas with this model. All of our marketing comes with a single, crystal clear call to action. No confusion. No decision fatigue. 

3. Leadership Focus Days. Businesses make decisions and drive change from the top down. Changing the way leaders think about pain and physical health create program ambassadors that funnel the message down through the organization. While we work from the bottom up with MSK screening for the masses we want to take special care of executives and leaders knowing they have the ears and respect of their teams. This is also of added benefits in executive health and wellness which can drive great results through decision making power, positive health habits, and resilience. Physical health provides tangible results and actions that are the gateway to all other areas of wellness like spiritual, mental, emotional, social, and even financial health. Amplifying these qualities in executives and leadership can have incredible long term impact on the oragnization.

Our ideal client currently is a hospital system. Hospital systems are typically losing money and our service can help create a hedge against declining reimbursements they are seeing year over year. They typically will range from 800-2000 employees that are lumped together in single locations or nearby, they are all structured almost identically, and have high MSK spending  due to the type of work being done by nursing and support staff.  A group this size typically does not have any form of solution in place or care navigation to make sure people get to the right service at the right time which means by installing MSK screening every year and dedicated care pathways for pain conditions we can drastically reduce wasteful spending and unnecessary surgical procedures for pain. This makes duplicating process and results even more repeatable and scaleable through hospital associations. Secondarily, hospitals are now engaging in direct contracting with employer groups in the local communities primarily in direct primary care services. By plugging into the hospital systems to serve its own employees and decrease their wasteful MSK spending, we can then become the hub for rehab for their external employer connections. The total addressable market is 7300 hospitals nationwide as well as another 38,000 companies falling between 800-2000 employees that we can target. And we would never turn down a larger client if it is the right fit, right opportunity, and drives our mission and impact forwards. I currently am getting connections into the local hospital system and have connections in the Indiana Hospital Association. If I can get one of them I can get most of them. 

One of the challenges with integrating with companies is having data to show results. As a newer company we do not have this data yet. If we are going to accelerate in a meaningful way we need data as a way to access better conversations with employer group and the benefits advisors that sit between the employer and their health plans. We are currently in discussions with the validation institute to create data plans as well as validation of our model. We would use our funding to install the model into 1-2 hospitals locally, partner with validation institute to collect meaningful data, and improve our technology to streamline engagement and delivery of our services to the end user. We have current clients that we could scale with funding as well as clients in the pipeline where would could use available funding to close the deal and provide a service free to the employer for 12 months in exchange data collection and contracted revenue in years 2-5 contingent on results in first 12 months.  What we do is different. The world deserves a better class of rehab. I will give it to them. The time is right for direct contracting with employers for a multitude of reasons. And even though I do take a long view in playing the infinite game of business, thoughtfully and intelligently, I do selfishly want to mop the floor Hinge Health and Sword.