Innovators Worth Watching: Hinge Health

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Feb 22, 2022

Our “Innovators Worth Watching” series spotlights interesting and potentially disruptive players across a spectrum of industries.

One in five US adults reported living with chronic pain in 2016, with 8% of US adults reporting that it limited at least one major life activity. Chronic pain is linked to several other health problems, such as depression, anxiety, reduced mobility, and opioid dependency. While there are several ways to manage chronic pain, ranging from physical therapy to medication to surgery, it is often something that people end up accepting as a part of their lives. 

Hinge Health seeks to redefine how patients manage their chronic pain. By using a combination of wearable technology and telemedicine, Hinge offers virtual physical therapy for patients experiencing musculoskeletal chronic pain. The platform also connects users to a health coach to help manage goals and develop care plans.

Hinge Health’s clinical success is already well documented, with each participant on average experiencing a 69% reduction in pain, and two out of every three chronic pain surgeries avoided. But do they also have disruptive potential? We put Hinge to our six-question test.  

1. Does it target people whose only alternative is to buy nothing at all (nonconsumers) or who are overserved by existing offerings in the market?

Yes. Hinge targets patients who are overserved by surgery as the solution to address their chronic pain. One of Hinge’s selling points is that 90% of their users claim they are less likely to pursue a surgical solution. Hinge offers those experiencing chronic pain a non-invasive, less expensive option. 

It also targets nonconsumers of traditional physical therapy, by making physical therapy more readily accessible to those with a time or budget constraint. 

2. Is the offering not as good as existing offerings as judged by historical measures of performance?

Yes. The health care industry typically sees surgery as the highest quality medical intervention. A non-surgical option would therefore be seen as “not as good” compared to historical performance measures, regardless of its success. Non-surgical treatment is proven to be as effective, and in many cases, a better alternative to surgery. 50% of MSK surgeries in the US are “unnecessary” when compared to MSK surgery rates in other industrialized countries.

This answer stays the same when compared to in-person physical therapy. The crux of Hinge Health is a series of self-guided physical therapy exercises. This self-run nature could be considered “not as good” as traditional physical therapy, which is done with the hands-on assistance of a trained professional; Hinge takes a “do-it-yourself” approach to exercises, so users complete their daily exercises without a physical therapist.  

3. Is the innovation simpler to use, more convenient, or more affordable than existing offerings?

Yes. The fact that Hinge is an at-home, self-guided program makes it more convenient than traditional physical therapy, and far more convenient than surgery. Each series of exercises is only fifteen minutes long, compared to the 30-60 minutes that is typical of in-person physical therapy, making them easier to fit into any schedule. 

Hinge is also free to use for employees and health plan members who have it as part of their benefits (Hinge Health is already offered by 600+ employers and health plans covering over 180,000 people). In-person physical therapy can cost upwards of $350 per session; and surgical fixes can cost almost $28,000

4. Does the offering have a technology that enables it to improve and capture a larger market over time?

Yes. Technology is where Hinge really shines. Hinge uses a combination of wearable tech, motion capture technology, and telehealth services to offer a comprehensive approach to at-home chronic pain management. Users are given a set of wearable devices and a tablet; through this, patients perform their set of exercises and are given corrections and feedback on their stretches and exercises in real time. Hinge sets up users with a personalized health coach, who is available to talk to patients about goals and areas of support. 

Hinge’s technology has already allowed them to expand their offerings to a larger market. Their telemedicine expertise allowed them to develop HingeConnect, an integral service that connects both in-person therapy and a Hinge-run clinical care team of health coaches, physical therapists, and orthopedic surgeons—an upward move from a team of just health coaches. Doing so allows for more targeted approaches to chronic pain care, as well as better communication with external providers. 

5. Is the technology paired with an innovative business model that allows it to be sustainable?

Yes. By partnering with employers and health plans, Hinge is able to increase their patient pool while offering a service that is both free to users who work where Hinge is a benefit, and sees a return on investment for businesses. Hinge will easily be able to maintain sustainability, especially if they keep partnering with more employers and health plans. 

6. Are existing providers motivated to ignore the new innovation and not feel threatened by it at the outset?

Yes. Even with the addition of a health coach, physical therapists may be motivated to ignore a virtual option in favor of a more hands-on approach. Surgeons will also be motivated to ignore it, as surgery is often seen as the best medical solution, and often health care incentives are aligned around surgical options; with fee-for service still the predominant reimbursement method in healthcare, providers and hospitals are incentivized to turn to more lucrative procedures, such as surgery. 

Hinge Health has the potential to disrupt both in-person physical therapy and surgical options for chronic pain. The self-guided component is more convenient for those with time constraints, and its business model makes it accessible to hundreds of thousands for free. Hinge is absolutely an innovator worth watching, and I look forward to seeing how they continue to revolutionize chronic care. 

Jessica is a research associate at the Clayton Christensen Institute for Disruptive Innovation, where she focuses on business model innovation in healthcare, including new approaches to population health management and person-centered care delivery.