Advocating for Better Osteoporosis Care in Medicare
A coalition of 35 leading health organizations is urging Medicare to take significant steps to improve post-fracture care for millions of seniors dealing with osteoporosis. These groups stress the immediate need for reforms to provide adequate support for over 10 million Americans affected by this chronic condition, particularly in light of the high number of fractures that occur each year.
The Significance of Fracture Liaison Services
These organizations are appealing to the Centers for Medicare & Medicaid Services (CMS) to incorporate payment models in the forthcoming 2025 Medicare Physician Fee Schedule (PFS) that back established post-fracture care coordination services, specifically known as fracture liaison services (FLS). At present, many patients lack access to these vital services, even though numerous studies have shown their effectiveness in lowering fracture risks and managing healthcare costs.
Highlighting Underused Services
In a recent draft PFS regulation, Medicare recognized the importance of follow-up services after fractures, identifying them as high-value care that is frequently underutilized. Stakeholders had the opportunity to share feedback on how payment policies could be modified to address current barriers to access. This acknowledgment represents a vital initial step toward better care for patients with osteoporosis.
Concerns About Proposed Changes
Despite these encouraging developments, concerns have been raised regarding whether the proposed coding and payment models will sufficiently address the care gap for preventing secondary fractures. Organizations, led by the Bone Health and Osteoporosis Foundation and the American Society for Bone and Mineral Research, voiced apprehension that the current frameworks might not close this gap effectively, especially since they impose considerable burdens on primary care providers.
A Call to Action from Health Leaders
Claire Gill, CEO of the Bone Health and Osteoporosis Foundation, stressed the necessity for a coherent coding system that guarantees comprehensive care for Medicare beneficiaries. She pointed out the potential financial benefits, explaining that effectively managing post-fracture care could lead to substantial savings for taxpayers while also enhancing patients' quality of life.
Support from the American Society for Bone and Mineral Research
Douglas Fesler, Executive Director of ASBMR, echoed these thoughts, commending CMS for its initial efforts to boost bone health outcomes. He urged the agency to finalize regulations that would standardize access to evidence-based post-fracture care, making it a standard practice rather than an exception.
Need for Structural Revisions
The coalition also called for updates to Medicare's TEAM payment model, which currently requires many hospitals to return fracture patients to primary care without sufficient support. Without additional incentives for FLS, there's a risk that numerous fracture patients may not receive the essential quality care they need, as primary care physicians often lack the time, resources, and training to adequately manage these complex cases.
The Role of Advocacy Organizations
The Bone Health and Osteoporosis Foundation has been a key player in the fight against osteoporosis since its founding in 1984. Its mission centers on promoting bone health and preventing fractures through education, advocacy, and research aimed at improving patient outcomes. Organizations such as ASBMR enhance the conversation within the scientific and medical communities, working to raise the standards of care for those facing bone-related challenges.
Frequently Asked Questions
What is the primary concern of health organizations regarding Medicare?
Health organizations are advocating for Medicare to implement better post-fracture care for seniors with osteoporosis.
What are fracture liaison services (FLS)?
FLS are specialized care coordination services designed to reduce fracture risks, which have been proven effective but are often underutilized.
Why is there a call for changes to the TEAM payment model?
The current model lacks sufficient incentive for providing quality follow-up care, which risks inadequate treatment for patients who have experienced fractures.
What potential impacts do proposed changes to Medicare have?
Improved Medicare regulations could result in better health outcomes for patients and considerable 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 reduce suffering through education and advocacy efforts.
