Newsletters

Spring 2009

Worldwide Economic Crisis
puts Osteoporosis Care in Peril

The stock market crash, downturn in real estate values, and severe limitations in lending have  affected all of us in one way or another. Skyrocketing health insurance premiums have contributed to the financial stress of individuals and businesses, with the federal government rightfully taking a serious look at healthcare reform. There is danger, however, that the baby (in this case, osteoporosis care) may be thrown out with the bathwater.

A 2004 report of the US Surgeon General identified osteoporosis as a major public health concern with serious consequences, including disability, death, and high costs due to fractures. The Surgeon General went on to say that osteoporosis is commonly not recognized when it is present, and commonly not treated. He challenged us all (doctors, patients, and health plans) to do better at identifying those of us who are at risk for fracture and see that appropriate treatment is given.

At the same time the Surgeon General is telling us to do more in caring for osteoporosis, other federal agencies and the private insurance industry are making it more difficult to do so. Medicare has reduced the reimbursement for bone density testing to a point that most facilities are not being paid enough to cover the cost of doing the test.

This has resulted in the closing of some facilities, with the eventual result that access to needed diagnostic services will be limited, with fewer patients being diagnosed with osteoporosis, fewer treated, and more fractures. Aside from the personal suffering caused by fractures, this has been estimated to cost Medicare (and the taxpayers) an extra $1.1 billion in fracture-related expenses over the next 5 years. But there is more. Medicare and health plans do not cover bone density testing for all patients who need it, and are restricting the use of this test to monitor patients being treated. Other useful osteoporosis tests, such as the measurement of vitamin D levels and bone turnover markers (See side bar on back page) are now commonly being denied.

While efforts to contain out-of-control healthcare costs are certainly needed, restricting care that improves our health and saves money is not appropriate. Want to do something to help? Learn more and send an email to your senators and congressperson by going to the website of the International Society for Clinical Densitometry (www.iscd.org) or the National Osteoporosis Foundation (www.nof.org). Contact Medicare or your health plan if you are denied services you need. Support healthcare savings don’t let the healthcare system deny essential services.

E. Michael Lewiecki, MD                                    
Lance A. Rudolph, MD

This page update 04/11/09