Hospital for Special Surgery scores $21M to spin off virtual physical therapy platform

Hospital for Special Surgery has announced $21 million in series A funding that will help launch RightMove Powered by HSS, a for-profit company independent of the nonprofit hospital.

The telehealth platform plans to bring HSS’ honed musculoskeletal care to all Americans through virtual physical therapy.

HSS believes that its creation and collaboration with RightMove will help address the $380 billion national musculoskeletal health burden while also offering a new model for telehealth. The telehealth platform expects to launch in the late second quarter of 2023 with partners or regional focuses yet to be determined, executives said.

The funding round, led by Flare Capital and HSS, will help develop RightMove’s technology platform and establish a nationwide network of specialty-trained physical therapists.

“We think this is something fairly unique because it is very clinically driven, quality driven telehealth; it's not gimmicky,” said Amy Fahrenkopf, M.D., president of HSS Health, senior vice president at HSS and interim CEO at RightMove. “It's a bit meat and potatoes, frankly. It’s part of why we think we had a bit of a leg up in this market where people are having trouble raising money. It’s not about gadgets or anything newfangled. It's just about providing outstanding care to the rest of the country.”

Fahrenkopf and HSS see RightMove as a model of patient-centered telehealth care backed by over a century of data and honed clinical guidelines. By collecting patient-reported outcomes metrics, RightMove hopes to bring the same craft to tele-rehab.

For 13 consecutive years, HSS has been named the premier center for musculoskeletal health with doctors reporting it as their preferred hospital for the specialty, specifically hip replacements, according to the hospital.

One in 2 U.S. adults experience musculoskeletal-related issues that lead many to unnecessary procedures, Fahrenkopf said.

Fahrenkopf will continue to fill the role of RightMove’s interim CEO while an executive search is underway. RightMove will initially start with two offerings: triage and direct access care.

Triage will take place in a 45-minute initial assessment with an HSS-trained physical therapist who will help direct patients to the next point of care. Not knowing where to go, unnecessary imagining, injections and repeated imaging—this is where Fahrenkopf sees the bulk of musculoskeletal waste.

“It’s been proven that early access to high-quality physical therapy will eliminate a lot of those unnecessary steps,” she said. “When physical therapists determine that you should go to a surgeon, the chances that you need surgery is considerably higher than when a primary care physician sends you to a surgeon.”

Direct access to nonsurgical virtual physical therapy will also be available for 95 conditions. Even without a physician referral, patients can access this care for issues like lower back pain and carpal tunnel syndrome.

When HSS pathways are followed, patients see roughly a quarter to one-third fewer visits with better outcomes than community physical therapy, Fahrenkopf said.

“RightMove has an advantage in that we're not two guys in a garage—and there's nothing wrong with two guys in the garage, they have created some amazing companies—however, when it comes to your healthcare, we really are based in extremely high quality, so we're not going to take the same chances,” she said. “We are very focused on providing outstanding care virtually when it's appropriate. We're not going to say everyone's appropriate just so that we can make money.”

Once the two initial areas of care are in place, and a nationwide network of physical therapists has been established, Fahrenkopf expects RightMove to step into postsurgical care requiring an initial in-person appointment.

She also sees the potential for supporting patients who have a home health aide in their at-home rehab. Especially for patients who are a fall or infection risk, she sees at-home, supported therapy as a wise option. She imagines Medicare Advantage plans will be interested in the service.

All care will be based on HSS’ expertise, including workflows, guidelines for care and physical therapist training developed by HSS’ rehab department. During the pandemic, HSS’ rehab stepped into the virtual world, gaining itself a Net Promoter Score of 96, executives said.

“Our rehab department has provided over 100,000 tele-rehab visits in just the past two years and has a track record of providing superior outcomes to community rehab at a lower cost and with an outstanding patient experience,” Fahrenkopf said. “So, this was an amazing base for HSS to build a company out of. We've never done this before and we are excited that in this market a 160-year-old hospital can start a company and raise money."

Fahrenkopf thinks RightMove is better suited as an independent, for-profit company leveraging HSS’ expertise in the field, and she believes its model will stand out compared to other players in the field.

As many new telehealth companies tout a value-based model, HSS has been practicing outcome-driven care since 1863, she noted. The hospital boasts the lowest complication and readmission rates in the nation for orthopedics and among the lowest infection rates.

With the spinoff model, RightMove is able to gather venture money to scale in a way that the nonprofit model wouldn’t allow in the same way. By selling to both employers and health plans, Fahrenkopf thinks the platform can uniquely be a value-based partner.

“HSS has a lot of employer partnerships in the New York area,” Fahrenkopf said. “We were asked repeatedly if we could provide this service to these large employers and their employees nationally. A lot of people don't realize how many legal and regulatory challenges there are in providing telehealth services nationally and most of the national telehealth services out there are primary care or mental health. You don't have really expert medical services provided at this level. It just made more sense for this to be a separate company; it was going to be difficult for HSS in the hospital to do it.”

Virtual physical therapy has seen rapid expansion in recent years. Hinge Health, valued at $6.2 billion, is a major player in the market. The telehealth company provides wearable technology for pain relief, computer vision and motion sensors for motion assessment and near-real-time interventions by integrating health data. 

Sword Health provides virtual surgical recovery support by connecting Sword doctors to patients wearing motion sensors at home. Cigna’s RecoveryOne uses visual assessments to guide users recovering from low back pain. UnitedHealthcare developed on-demand virtual programs informed through patient data and reported outcomes.