Beyond Surgery: How Non-Operative Centers of Excellence (COEs) Are Redefining MSK Care Solutions for Employers

As benefits leaders consider 2026 renewals and plan ahead for their 2027 strategies, new opportunities are emerging in how organizations approach musculoskeletal (MSK) care. While traditional Centers of Excellence (COE) have focused on surgical interventions, a new approach, non-operative COEs, prioritize conservative treatment and early intervention over surgical treatment. This shift represents a strategic response to mounting cost pressures driven by inappropriate utilization of surgery, and recognizes that many MSK conditions can be effectively managed without surgery.

The MSK Crisis Demanding Immediate Attention

Recent data surrounding MSK care in the U.S. paints a sobering picture. A 2024 article published in Elsevier’s Lancet Regional Health – Americas journal reports MSK diseases are “the leading cause of years lived with disability” and “an increasing health burden and economic cost of $980 billion annually.” The study found that research involving all types of MSK diseases are underfunded, especially neck pain (0.83% funded), low back pain (13.88% funded), and osteoarthritis (35.08% funded).¹