Surgical bundle drives dramatic improvements in worker recovery

1. We’re now able to offer a high-quality, efficient surgical bundle model that supports better recovery outcomes.
2. This new model benefits all workers’ comp stakeholders: injured workers, employers, payers and providers. 
3. It is easy to implement, with minimal “lift” required. Optum and MinWorx have worked together to solve the traditional hurdles of payer adoption.

Traditional surgical bundles — common for shoulders, hips and knees — package an entire episode of care (from surgery through rehabilitation) into a single price. The organization offering the bundle takes on financial risk for complications or out-of-bundle services, relying on their ability to manage care efficiently and ensure high-quality outcomes.

In workers’ compensation, the adoption of bundled care has been limited because of implementation hurdles — the very challenges that Optum and MinWorx have addressed with our new program.

The “MIN” in MinWorx Health stands for “Minimally Invasive Network.” With the motto “Healthcare moves slow, but we move fast,” MinWorx is passionate about accelerating access to proven, innovative procedures.

By researching major inefficiencies in injured worker care, we have learned that new medical procedures can take up to 20 years to move from invention to widespread adoption. Even after a decade of safety and clinical efficacy validation, provider adoption lags due to economic disincentives, as procedures are shifted from high-revenue surgical centers to lower-cost office settings.

MinWorx shortens that timeline dramatically by forming a Center of Excellence network of trained providers throughout the country and connecting them with payers like Optum. This allows us to bring proven, minimally invasive procedures to injured workers now, rather than waiting another decade.

At the moment, we are focused most heavily on work-related carpal tunnel syndrome (CTS), which is one of the most common workplace-related conditions.

• 13 million Americans suffer from CTS, but only 400,000 undergo surgery annually.¹
• Many avoid surgery because of financial fears and uncertain outcomes. Almost 70% of Americans live paycheck to paycheck and can’t afford a long recovery.² 

Prolonged suffering leads to sleep disruption, mental health strain and lost employment. Those affected by CTS often delay treatment and live with ongoing pain, with 80% reporting they wake up multiple times a night, worsening anxiety and depression. A Washington State study³ of nearly 9,000 claims found that six years after closure, workers who had carpal tunnel claims were twice as likely to be unemployed, underscoring the long-term impact of untreated or poorly treated cases.

Traditional open, or “mini-open,” carpal tunnel surgeries involve incisions in the palm, which cause extended pain, higher complication risk and longer recovery times. Endoscopic techniques were developed to improve outcomes; however, limited visibility during surgery has resulted in an elevated risk of nerve injury.

Under the traditional system, an injured worker’s care path for CTS is long and fragmented:

1. Initial provider visit and bracing
2. Medications, then multiple rounds of physical therapy
3. Injections offering temporary relief
4. Eventually, surgery — followed by post-op physical therapy

This process can last 18 to 31 months, depending on the state, with significant medical and indemnity costs averaging $35,000 per claim.

Sonex Health is a clinical partner with MinWorx Health. Founded by Dr. Jay Smith and Dr. Darryl Barnes, both formerly at Mayo Clinic, Sonex developed an ultrasound-guided carpal tunnel release device, UltraGuideCTR, which allows CTR surgery to be performed through a tiny incision in the wrist under local anesthesia. Moving the incision off the palm to the wrist is one of the key innovations that reduces downtime, discomfort, and recovery barriers for injured workers.

Using ultrasound technology, which has advanced exponentially in resolution, physicians can visualize nerves, arteries and tendons in real time, eliminating the blind spots of endoscopic surgery. This makes the procedure safer, faster and more cost effective.

Since its inception in 2014, more than 46,000 procedures have been performed using the UltraGuideCTR device, supported by 16 peer-reviewed studies covering over 1,300 patients and 45 physicians.

The results are remarkable:

• Faster return to work: Median 2–7 days, compared to 2–4 weeks or more for traditional methods.
• Minimal pain and scarring: Tiny incision outside the palm; no stitches required in most cases.
• Performed in-office: No need for an operating room, anesthesia team or fasting.
• Safe and effective: Can be performed on patients with comorbidities like diabetes or hypertension.
• Efficient: Both hands can be treated in one session, reducing the overall recovery cycle.

Yes. Sonex Health has developed a second device, UltraGuideTFR, for trigger finger — another common condition among injured workers. This procedure, also ultrasound guided, offers visual and functional advantages over traditional open surgery, resulting in remarkable benefits:

• Performed under local anesthesia
• Requires no sutures, resulting in minimal scarring
• Enables immediate return to function 

Over 8,000 trigger finger procedures have been successfully performed to date using the Sonex Health device, UltraGuideTFR.

Yes. Injured workers experience:

• Quicker pain relief and return to work
• Less fear of surgery due to smaller incision and faster recovery
• Improved mental health and quality of life

Payers and employers see:

• A dramatic reduction in medical and indemnity costs
• Faster claim resolution
• More predictable outcomes and simplified administration

And importantly, providers have:

• Access to new technology that improves outcomes and efficiency
• Opportunities for growth within a national minimally invasive network

The proprietary surgical bundle offered by Optum and MinWorx Health is a transformative advancement in value-based workers’ compensation care. By combining leading-edge ultrasound technology, a minimally invasive surgical approach, and a streamlined bundled payment model, the program:

• Reduces claim cost and duration
• Improves patient satisfaction and recovery
• Removes barriers to implementation

It’s a win-win for all stakeholders — and a clear example of how innovation, data and collaboration can redefine what’s possible in workers’ compensation healthcare delivery.