National Health Groups Urge Medicare to Enhance Osteoporosis Care
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Advocacy for Improved Osteoporosis Care in Medicare
A coalition of 35 prominent health organizations is calling on Medicare to take decisive action to enhance post-fracture care for millions of seniors suffering from osteoporosis. These groups emphasize the urgent need for reforms to ensure adequate care for over 10 million Americans affected by this chronic condition, aiming to address the alarming number of fractures that occur annually.
The Importance of Fracture Liaison Services
The organizations are urging the Centers for Medicare & Medicaid Services (CMS) to integrate payment models in the upcoming 2025 Medicare Physician Fee Schedule (PFS) that support proven post-fracture care coordination services, specifically known as fracture liaison services (FLS). Currently, many individuals are left without access to these essential services despite extensive research demonstrating their effectiveness in reducing fracture risks and controlling healthcare costs.
Recognition of Underutilized Services
In a recent draft PFS regulation, Medicare acknowledged the significance of follow-up services after fractures as high-value care that is often underutilized. Stakeholders were invited to provide input on how to reshape payment policies to tackle existing barriers to access. This acknowledgment is a critical first step toward improved care for osteoporosis patients.
Concerns Regarding Proposed Changes
Despite these promising developments, the collective voiced concerns about the likelihood that the proposed coding and payment models will adequately address the care gap for secondary fracture prevention. Organizations, led by the Bone Health and Osteoporosis Foundation and the American Society for Bone and Mineral Research, expressed that the existing frameworks may not effectively close this gap, particularly as they place extensive burdens on primary care providers.
Call to Action from Health Leaders
Claire Gill, CEO of the Bone Health and Osteoporosis Foundation, articulated the need for a coherent coding mechanism that ensures Medicare beneficiaries receive comprehensive care. She highlighted the potential economic benefits, stating that effectively managing post-fracture care could result in significant savings for taxpayers while also improving patients' quality of life.
Support from the American Society for Bone and Mineral Research
Douglas Fesler, Executive Director of ASBMR, echoed this sentiment, praising CMS for its initial steps towards enhancing bone health outcomes. He urged the agency to finalize regulations that would standardize access to evidence-based post-fracture care, making it the norm rather than an exception.
The Need for Structural Changes
The coalition also called for revisions to Medicare's TEAM payment model, which currently mandates many hospitals to refer fracture patients back to primary care without adequate support. Without additional incentives for FLS, the risk remains that many fracture patients may not receive the quality care they require, as primary care physicians often lack the necessary time, resources, and training to manage these complex cases effectively.
The Role of Advocacy Organizations
The Bone Health and Osteoporosis Foundation has been at the forefront of efforts to combat osteoporosis since its establishment in 1984. Their mission revolves around promoting bone health and preventing fractures through education, advocacy, and research endeavors tailored to improve patient outcomes. Organizations like ASBMR further enhance the dialogue within the scientific and medical communities, striving to elevate the standards of care for individuals suffering from bone-related challenges.
Frequently Asked Questions
What is the primary concern of health organizations regarding Medicare?
Health organizations want Medicare to implement better post-fracture care for seniors suffering from osteoporosis.
What are fracture liaison services (FLS)?
FLS are specialized care coordination services designed to reduce fracture risks and are proven effective yet often underutilized.
Why is there a call for changes to the TEAM payment model?
The current model does not provide enough incentive for quality follow-up care, risking inadequate treatment for fracture patients.
What potential impacts do proposed changes to Medicare have?
Improved Medicare regulations could lead to better health outcomes for patients and significant savings for taxpayers.
What is the mission of the Bone Health and Osteoporosis Foundation?
Founded in 1984, it aims to promote strong bones, prevent osteoporosis, and minimize suffering through education and advocacy.
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