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How Kiio’s on-demand digital platform for musculoskeletal pain cuts wasteful spending

Kiio CEO Lydia Zeller talks about the digital musculoskeletal (MSK) startup that guides people through personalized therapeutic programs to reduce and prevent back and joint pain using only their smartphone or tablet. 

What’s the genesis story of Kiio and your role there? 

Kiio started in 2012 with a mission to transform musculoskeletal care, using in-clinic  sensor technology combined with a patient-facing mobile app. I  began as a volunteer, and then was asked to consult on various financial management activities. My role evolved to include almost every aspect of the business—from writing  our first employee handbook and creating policies to interacting with investors, writing  grants, and creating our content library of therapeutic exercises. In 2016, I became responsible for product strategy, where my passion found its home.  

Near the end of 2016, we made an intentional decision to reevaluate our technology  stack and how we could enhance it to skate to where the puck is headed. I did a deep  dive into where healthcare was going, looking at what was possible in innovative care  delivery models and the pain points of those paying for healthcare. I wanted Kiio to  combine the best in technology with evidence-based medicine to provide MSK  consumer-centric care to more people. Firmly believing digital therapeutics was that  path, I drove our shift into the digital MSK care space, with a platform offered through  health plans and employers. We developed Kiio’s product hand-in-hand with our first  health plan clients, and have remained client- and member-focused, expanding the  product to cover the continuum of MSK care. 

Lydia Zeller

I led the product function until 2020 when I transitioned to CEO. It was a natural  change, supported by both our founding CEO and our Board. We had just closed a  funding round and had the opportunity to accelerate team growth and product  development. I’m so excited about what we have accomplished since then and where we  are headed. 

What specific need are you seeking to address in healthcare? 

Kiio is on a mission to be the easiest, most effective – and most cost-effective – way for  payers and individuals to reduce the physical, emotional and financial burden of  musculoskeletal pain.  

MSK pain has a tremendous impact on individuals as well as employers and health  plans. Each year, one in every two people will have an MSK issue, creating significant  physical, emotional, and financial burdens. We often think of costs as only impacting  the health plan or employer. Yet, in addition to pain and the associated impact on 

mental wellbeing, individuals are shouldering significant costs – particularly time off  work and the out-of-pocket costs under today’s high deductible plans.  

Payers also incur tremendous costs—whether a commercial, Medicare Advantage, or  Medicaid health plan, or an employer self-funding their plan. MSK issues cost more  than cancer, diabetes, or heart disease and represent one-sixth of all spending in the US  health care market. Self-funded employers experience 1.5 times the burden due to lost  productivity, missed workdays, disability costs, and workers’ comp costs

Traditional healthcare has done a poor job of managing MSK conditions, often  recommending wasteful tests or treatments that are not clinically indicated and may add risks in the case of opioids or surgery. For example, patients experiencing newly  diagnosed chronic musculoskeletal pain are prescribed opioids more often than physical  therapy, counseling, and other nonpharmacologic approaches

At Kiio, we’ve worked to create a member-centric, evidence-based approach to  musculoskeletal care so that people receive immediate access, 24/7, to personalized care  that is effective, on-demand, and convenient.  

Our claims-based studies have demonstrated how Kiio’s immediate access and proven  care reduce urgent care visits, prescription pain medication, and over-used aggressive  diagnostics and treatments.  

Kiio’s quick-start solution is the only one that doesn’t require waiting for equipment,  scheduling a clinical consultation, or mastering the learning curve of trackers and  sensors. You can answer our screening questions at 3 AM on a Saturday, download  Kiio, read your first knowledge material, do your first personalized exercises, and be on  your way to feeling better within five minutes. Now that’s truly impactful. 

What does your product do? How does it work? 

Kiio is a digital solution that provides individualized, on-demand exercise therapy  combined with education and support for people who want to relieve or prevent back  and joint pain. When a member first engages with us, they answer a five minute  screening questionnaire to assess whether we’re appropriate for them and identify their  specific pain and risk profile. 

We designed Kiio to be broadly applicable to help as many members as possible. With  Kiio’s digital front-door technology, the 80% of the folks who screen into Kiio get  immediate access to a personalized care program specific to their subset of pain within  each joint. (The 20% not appropriate for Kiio are immediately linked to in-network  care.) So not everybody with knee pain is going to get the same exercises. Members  download Kiio to their smartphone or tablet. Over 50% of Kiio members start their  tailored program immediately.  

The app has three essential elements. 

  1. Therapeutic exercises with symptom specific tracks built on evidence-based clinical protocols. 
  2. Education modules authored by experts on how pain works with tips to manage it and modify behavior for sustained improvement. 
  3. Support, both AI-driven and through a live care team. 

As members engage with their program, we’re querying them on their pain, function,  mental well-being, and how they feel the program is helping them. Our software uses  that feedback to progress members at their own pace and provides contextual messaging  and content. Although most Kiio members interact solely digitally, members also have  access to one-on-one interaction with our human care team if they want some extra  coaching, additional support, or have questions.  

With Kiio, we’re meeting members where they are, enabling them to take charge and  find relief. Everything happens exactly when they want it to happen. Members have  access to Kiio for a year from signing up so that they can maintain the benefits they’ve  gained and prevent and manage flare-ups. 

Is this your first healthcare startup? What’s your background in  healthcare? 

My path may be slightly different from some healthcare startup CEOs in that Kiio was  my first foray into healthcare. I firmly believe that there is a significant benefit to  bringing fresh perspectives to healthcare, provided that medical subject experts are  driving a product’s clinical aspects. Healthcare has much to learn from consumer  services in terms of personalization, immediacy, human-centered design, ease-of-use,  and creating solutions that are “fun” to engage with and bring joy. 

What is your company’s business model? 

We have a utilization-based business model where our clients don’t pay unless we  engage their members. Because Kiio doesn’t rely on sensors or other hardware to be  effective, and because we are using AI to deliver evidence-based care instead of  depending on one-to-one virtual care, we can keep the price point relatively low. Clients  pay a one-time fee when a member completes our screening and a second fee when a  member engages with their digital care program. That fee covers complete care for a  year. 

We either invoice those fees directly to the client or bill them through the health plan’s  claim systems using CPT codes. Claims billing is particularly advantageous for  employers because it allows them to flow the fees through the health plan and avoid  costs on their administrative side. 

Ultimately, we believe that the most appropriate place for solutions like Kiio is to be funded by the health plan and available to people as a fully covered health benefit. Kiio  qualifies as preventative care and is a 100% covered benefit, with first-dollar coverage  even under a high deductible plan. Members pay nothing out of pocket for Kiio, which  aligns with the accessible, affordable, and high-value care we are committed to  providing. Still, not everybody has access to Kiio through their employer or health plan.  We’ll soon be launching a direct-to-consumer option in partnership with a major  national healthcare retailer for those people.

Do you have clinical validation for your product? 

We do. Since going live with members at the beginning of 2017, we’ve measured Kiio’s  clinical impact, including improvement in pain and function. It’s significant that across  our diverse book of business, 8 in 10 Kiio members experience clinically significant  reductions in pain and better function. We have also seen strong results tied to mental  wellbeing as well as workplace productivity. We are proud to have worked with clients  and demonstrated strong results across all lines of business. 

On the cost side, we’ve done four longitudinal claims-based database studies with clients  to assess the impact of Kiio on their costs. In those studies, we’ve seen up to 64 percent  reduction in medical spend, including up to 88 percent reduction in opioid utilization. 

We are humbly proud of these results – and personally passionate about their impact on  individual members and clients. We hold our core values strong and are dedicated to  delivering measurable value to our members and our clients. 

To learn more about how Kiio can help reduce pain, lower costs, and empower  members, visit the company’s website.

Featured Photo: Prostock-Studio, Getty Images

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