Imagine if you could save hundreds of lives and tens of millions of dollars each year in Arizona, prevent countless more health complications, and relieve a growing burden on our state?
Our Congressional delegation can do all of that by addressing osteoporosis and our bone health crisis.
Only Sen. Kyrsten Sinema and Reps. Ruben Gallego and Raul Grijalva have signed on to co-sponsor legislation that can deliver these positive results – the Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act (S.283/H.R.2693).
It’s time for Congress to act is now.
Half of all females age 50 and older are at risk of breaking a bone due to osteoporosis or low bone density. While osteoporosis is common, it is highly underdiagnosed and undertreated. Many people don’t know they have the disease until they break a bone.
Broken bone recovery for someone with osteoporosis can present many challenges, including repeated fractures, hospitalizations, long-term care needs, and even death. In fact, as many as one in four adults aged 50 and over dies within 12 months of a hip fracture, and one in four spends the rest of their days in a nursing home, which many patients fear more than death.
We have firsthand experience with the devastating impact of osteoporosis. In fact, one of us recently spent a month caring for a parent who has broken her wrist, finger and femur and suffers from very poor posture and a loss of independence.
Fortunately, there is hope. A brief, inexpensive test called dual-energy X-ray absorptiometry screening (DXA) is the gold standard for diagnostic testing. It can help doctors know if their patients are at risk for osteoporosis.
The DXA test is recommended for all women over 65 and those under 65 with risk factors, and for men at increased risk for osteoporosis. However, fewer Arizonans are accessing this test since the Medicare reimbursement rate has dropped an astounding 70 percent since 2006.
It’s no longer economically feasible for many clinicians to maintain the equipment and administer these tests.
This decline in testing has had tangible effects in Arizona. It is estimated 110,600 fewer women have received a DXA scan since 2008, shortly after the significant reimbursement cuts began. This has resulted in an estimated 1,393 additional hip fractures and 304 additional hip fracture-related deaths per year.
It also has hit the state’s bottom line, as treating the additional hip fractures alone has cost Medicare $58 million, according to Braid-Forbes Health Research, LLC, which updated the data from 2018.
With a focus on diagnostic testing, we can reverse these trends. A 2019 study in a peer-reviewed journal found increasing DXA screening could have substantial benefits, preventing 3.7 million fractures and reducing total direct medical costs of osteoporosis by nearly $55 billion through 2040.
We already know that one in two women, and up to one in four men, after age 50 experience an osteoporosis-related bone break. We also know that increased access to DXA scans can help Arizonans and other Americans know their risk for osteoporosis and related fractures before a bone break, so they can get needed treatment and care.
But decreased reimbursement for testing is preventing wider access. We call on our elected leaders in Congress to support increased access to DXA diagnostic testing, and to sign on now to S.283 and H.R.2693. Lives are at stake.
Dr. Michael Maricic is a clinical associate professor at the University of Arizona. Dede Socha is a physical therapist and peer educator for American Bone Health.