Medicare could save billions of dollars if secondary fractures could
be prevented with improved osteoporosis screening, according to a new
National Osteoporosis Foundation report conducted by Milliman.
Milliman used administrative medical claims data from a Medicare Limited Data Set to identify new
osteoporotic fractures
not associated with a high-trauma event among Medicare fee-for-service
beneficiaries in 2015. The postfracture follow-up period to assess the
economic and clinical burden associated with fractures lasted two to
three years.
The researchers found that about 4 percent of Medicare beneficiaries
suffered a fracture in 2015. Spine and hip fractures were the most
common types identified, accounting for 40 percent of all osteoporotic
fractures. More than 40 percent of patients with a new osteoporotic
fracture were hospitalized within one week after the fracture (among
those with a hip fracture, 90 percent were hospitalized). More than one
in seven Medicare patients with a new osteoporotic fracture suffered
another fracture within 12 months of the initial fracture, and nearly
one in five with a new osteoporotic fracture developed a pressure ulcer
during follow-up. One in five Medicare beneficiaries died within 12
months following a new osteoporotic fracture. In the year after a new
osteoporotic fracture,
medical costs
were more than twice the costs incurred in the 12-month period prior to
the fracture for the same beneficiary, yielding an incremental annual
medical cost of $21,800 for a new osteoporotic fracture. An estimated
307,000 Medicare fee-for-service beneficiaries had a subsequent fracture
during two- to three-year follow-up, which the researchers estimated
accounted for $6.3 billion in allowed cost to Medicare. Fewer than one
in 10 female Medicare beneficiaries were evaluated for osteoporosis with
a bone mineral density test within six months of a new fracture.
“Increased focus on the identification and management of individuals
who have experienced an osteoporotic fracture through a secondary
fracture prevention program may lead to reduced rates of subsequent
fractures and result in
cost savings to payers, such as Medicare,” the authors write.
