Georgia’s congressional leaders need to address need for osteoporosis testing
With all the talk of healthcare costs and strained budgets, it is surprising to note that Georgia needlessly racks up an annual $40 million cost to Medicare because of a rise in hip fractures caused by a decline in testing for osteoporosis (source: Braid-Forbes Health Research, LLC updated these data from 2018).
This financial and related human toll has a cost-effective solution that would benefit patients and reduce costs for the healthcare system. But it requires the support of Georgia’s congressional delegation, and Congress overall. It’s time to pass the Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act (S.283/H.R.2693).
In Georgia and around the country, millions of people suffer from a disease they don’t even know they have. In fact, some 54 million Americans have osteoporosis or low bone mass that puts them at risk for fractures.
A woman’s risk of fracture is more than her risk of breast, uterine or ovarian cancer combined. A man is more likely to experience an osteoporosis-related fracture than prostate cancer. Yet, nearly 80 percent of older Americans who suffer bone breaks are not tested or treated for osteoporosis. This is outrageous since one in two women and one in four men over the age of 50 will experience a fracture in their lifetime. Worse yet, after a fracture fewer than 20% of individuals are provided follow-up treatment or medication.
Most people are unaware of their personal risk of osteoporosis because the progression of bone loss occurs without any pain or symptoms. The disease first announces itself in the form of a broken bone. The first fracture is a major predictor of more fractures, so early diagnosis and treatment could prevent painful and debilitating consequences.
This is where the solution comes into play. Dual-energy X-ray absorptiometry screening (DXA), a bone mineral density test, is the diagnostic testing gold standard. It is low risk, quick and painless, and it is critical to help Americans know their risk before they experience a painful bone break and to prevent further costly complications.
Unfortunately, DXA scans are declining because the Medicare reimbursement rate has dropped 70% since 2006. It’s no longer economically feasible for many healthcare providers to maintain the equipment and administer the tests. There was a 14% drop in DXA physicians right here in Georgia (source: Braid-Forbes Health Research, LLC updated these data from 2018). Declines in reimbursement resulted in diminished osteoporosis diagnosis and treatment, causing more painful fractures.
As a retired nurse practitioner specializing in menopausal women’s health, I’ve seen the impact of osteoporosis firsthand. In the many workshops I have conducted with patients, I find they are unaware of their risk.
Screening provides a “T-score” that measures bone density — much like cholesterol measures the risk of heart disease. Most consumers have no idea of their “numbers” when it comes to their bones. Professionals diligently weigh their patients, take their blood pressure, order mammograms and do Pap smears – but ignore the skeleton.
Patients need information, screening, and treatment in order to protect themselves prior to and following a fracture. Healthcare professionals need to order screening and treatment in greater numbers.
We ask our Georgia congressional delegation to appreciate the consequences of lowered DXA reimbursement on the bone health crisis in Georgia and America at large. S-283/HR-2693 presents a unique opportunity for lawmakers to help turn the tide on the epidemic of osteoporosis. Please join Congressmen John Lewis, David Scott, Drew Ferguson and Hank Johnson in supporting this bill. We need your help to restore access to this cost-effective and life-saving diagnostic test. Please act now.
Sharon Baker is the president and founder of the Rome, Ga.-based Women’s Information Network Inc., a nonprofit that aims to educate and empower women about health and wellness through information and networking.
This story was originally published February 12, 2020 at 6:30 AM.