The ongoing debate on reducing Maine’s health care spending often focuses on prevention. We know many examples demonstrating preventive care’s value, like that of the woman whose mother had a hip fracture and ended up in a nursing home until she died. Upon learning that her mother’s fracture was caused by osteoporosis, the woman got tested and is now on treatment to strengthen her bones, to avoid the same fate.
We have countless stories of others significantly affected by osteoporotic fractures. Osteoporosis is common, yet dramatically underdiagnosed and undertreated – to the point where breaking a bone is the first clue someone has it. Thankfully, Sen. Susan Collins is leading an effort, along with Sen. Angus King and Rep. Chellie Pingree, to help more Mainers – and Americans – get proper diagnosis and treatment. And, more policymakers must join them.
After age 50, one in two women and up to one in four men experience an osteoporosis-related bone break. Broken-bone recovery for someone with osteoporosis presents a host of challenges, such as repeated fractures, hospitalizations and long-term care needs – or worse. For example, one in three adults aged 50 and over dies within 12 months of a hip fracture, and one in four ends up in a nursing home, which many patients fear more than death.
As you might expect, these complications also come at a significant cost to the health care system. In 2018, annual direct medical costs associated with osteoporotic fracture were estimated to be $48.8 billion, with costs projected to increase. These numbers are staggering.
What if we told you that one brief, inexpensive test could help assess the risk of breaking bones before the first fracture? Dual-energy X-ray absorptiometry screening, a bone density test, is the gold standard for diagnostic testing. It is recommended for all women over 65 and those under 65 with risk factors, as well as for men at increased risk for osteoporosis.
While a seemingly simple solution, DXA scans are on the decline. Because the Medicare reimbursement rate has dropped 70 percent since 2006, it’s no longer economically feasible for doctors to administer them and maintain the equipment. DXA scan reduction has resulted in diminished osteoporosis diagnosis and treatment, leading to an increase in fractures. In Maine, it’s estimated that more than 32,006 fewer women have received a DXA scan since 2008, resulting in an estimated 447 additional hip fractures and 98 additional hip fracture-related deaths.
More screening and treatment mitigate osteoporosis’ personal and economic tolls. A recently published study in a peer-reviewed journal found that increasing DXA screening could have substantial benefits, preventing 3.7 million fractures and reducing both direct and indirect costs of osteoporosis by nearly $55 billion through 2040.
We thank our officials for their policy leadership, as increasing Medicare reimbursement for this cost-effective, inexpensive test can increase access to potentially life-saving diagnostic testing. It is critical that others in Congress support this legislation to protect more Americans from fractures and achieve cost-savings for the system. Passing this legislation in the House and Senate will save billions of dollars, but more important, it will save lives. Congress must seize the moment.
Comments are not available on this story.
Send questions/comments to the editors.