Osteoporosis is a significant problem in older people, especially women. Osteoporosis is a major risk factor for hip fractures, and hip fractures are quite problematic. Almost half of those who suffer a hip fracture never regain their prior level of mobility. Mortality rates in the first year after a hip fracture rise substantially compared to age-matched people without a hip fracture. By reducing osteoporosis, the risk of hip and other fractures can be reduced, along with lessening the morbidity and mortality that follows in the wake of these fractures.<\/p>\n
For this reason, osteoporosis screening and management is one of the measures that Medicare looks at closely. Clinicians\u2019 performance on this measure affects Medicare Stars Ratings and HEDIS measures, and are among the ways that clinicians, medical groups, and health plans are evaluated and graded on their quality.<\/p>\n
As is well-known, osteoporosis does not typically cause symptoms until a fracture occurs. But osteoporosis is easy to screen for. Although there is some ongoing controversy over who should be screened and when, the most common recommendation is to do bone density testing in women ages 65 and older. A particular subset of women for whom screening is universally accepted is older women who have sustained any kind of fracture. A fracture in an older woman, especially a fracture due to low-level or minor impact, indicates a high likelihood that osteoporosis is present.<\/p>\n
Medicare is very tuned in to this population. They look carefully at women ages 67 and over who have had a fracture, and require that either the woman has bone density testing within 6 months of the fracture, or has been treated with an osteoporosis medication within 6 months of the fracture. While external regulatory requirements can feel burdensome, this measure is clinically grounded and can be a significant marker for high quality care. By insuring that our older women with fractures are evaluated for osteoporosis and treated where necessary, we can improve our patients\u2019 quality of life in their later years.<\/p>\n
For members covered under PartnershipAdvantage, our Medicare product, we are not doing well on this measure. Our most recent data show that only one in five older women in the program with a fracture\u00a0are receiving the recommended evaluation and treatment. Patients in the older age group often have a lot of issues that need to be addressed in short office visits and it can be difficult to respond to every issue on the table. Fractures are usually identified not in the PCP\u2019s office, but in an ER or other setting, and this makes it harder for PCP\u2019s to know when a fracture has occurred. But if you do become aware of a broken bone in an older woman, we encourage you to do bone density testing or insure the woman is already on osteoporosis medication.<\/p>\n
Richard Fleming, MD<\/p>\n","protected":false},"excerpt":{"rendered":"
Osteoporosis is a significant problem in older people, especially women. Osteoporosis is a major risk factor for hip fractures, and hip fractures are quite problematic. Almost half of those who suffer a hip fracture never regain their prior level of<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[6,15,13],"tags":[],"class_list":["post-495","post","type-post","status-publish","format-standard","hentry","category-formulary-pharmacy-issues","category-medical-practice","category-prevention"],"yoast_head":"\n