RosettaFest 2025 Recap: The Future of MSK is Local
At this year’s RosettaFest, one big idea kept coming up: the U.S. healthcare system is broken, but the solutions are already here—and they’re right within our communities. Dave Chase, co-founder and CEO of Health Rosetta, reminded us that employers and communities don’t need more mega-systems, more middlemen, or more digital-only promises. They need local healthcare relationships that deliver better outcomes at lower cost.
Nowhere is that clearer than in musculoskeletal (MSK) care.
Digital MSK Showed Us the Demand (and the Limits)
Our conversations at RosettaFest confirmed what many employers and providers likely already know: digital MSK startups highlighted the MSK cost problem and proved the demand for conservative care, but virtual-only solutions aren’t enough. Utilization rates remain in the single digits, and employees aren’t sticking with it.
The reason is simple. People want in-person care from trusted providers in their communities. 64% of adults—including a majority of Gen Z and Millennials—prefer in-person healthcare at least some of the time. When it comes to PT, “physical” is in the name for a reason.
Taking a Cue from Direct Primary Care
At Hint Health’s DPC Summit, one theme came through clearly: Direct Primary Care has already proven the model. When employers invest in local, first-line access, employees get care they trust, employers see meaningful savings, and providers are paid fairly without red tape.
The sessions highlighted everything from expanding DPC service lines to employer adoption trends, all underscoring the same point: DPC works because it aligns the interests of patients, providers, and payers. That’s the same alignment physical therapy can create in musculoskeletal care—where costs are high, outcomes vary, and local access makes all the difference.
Physical therapy is ready for the same leap. In fact, states like Utah now recognize PTs as primary care providers for musculoskeletal conditions, reflecting a growing belief that PT should be the first stop for MSK care. That recognition creates a policy and cultural tailwind for employers and brokers to act, especially while building thoughtful self-funded plans.
Where PT Can Go From Here
For self-funded employers, MSK is almost always a top-three cost driver. Every unnecessary MRI, prescription, or surgery inflates claims spend, while delayed or poor-quality care drives absenteeism or further complicates recovery.
Local PT practices can flip that script. By making PT the front door for MSK:
- Employers save on avoidable high-cost care
- Employees get faster access to care they trust and want
- PTs are paid fairly for delivering better outcomes, without insurance overhead
This is pure alignment: lower costs, better care, stronger communities.
The Direct Opportunity
The digital MSK boom proved there’s demand. Now PT practices have the chance to meet it in a way that actually works—direct contracts with local employers. This model is already producing higher utilization, better outcomes, and stronger reimbursement than insurance or digital-only competitors.
Employers don’t need another point solution. They need trusted local partners. PT clinics are already embedded in their communities, already solving MSK, and with Employer Direct, they’re ready to engage directly.
Healthcare costs are rising faster than most employers can absorb. Catastrophic claims may dominate the headlines, but it’s the chronic, controllable costs like MSK that make the difference—and every community in America already has a trusted provider that can help with it.
That was the takeaway from RosettaFest: the future of MSK is local.
👉 Second Door is helping PTs and employers take this step together. If you’re a provider, see a demo of our platform. If you’re an employer or benefits professional, set up a meeting.
