Here in Maine, we are known for being a hardy bunch and pride ourselves on a life of hard work and cherishing our time outdoors. But with that comes the wear and tear on our bodies and especially our bones. Unfortunately, this leaves us particularly vulnerable to diseases such as osteoporosis which can weaken our bones and increase our chances of breaks, especially as we age.
Sen. Susan Collins is now lead sponsor of a common-sense bill that will restore Medicare funding for preventative bone density screenings. Stock-Asso/Shutterstock.com
More than 10 million Americans suffer from osteoporosis, and an additional 44 million are at risk of the disease because of low bone mass. One in two women over the age of 50 (versus one in four men) will break a bone in their lifetime because of the disease. For women aged 55 and above, these incidents lead to more hospitalizations and greater health care costs than heart attacks, strokes and breast cancers combined.
Just one fracture can mean the difference between living independently and relying on constant care. In fact, 24% of hip fracture patients aged 50 and over die in the year following the fracture.
In our state, one in five residents is over the age of 65, and nationally, we know that the number of Americans aged 65 and older is projected to nearly double from 52 million in 2018 to 95 million by 2060. Fortunately, an easy and effective way to screen for osteoporosis can dramatically reduce the rate of fractures. Preventative bone density screenings, or DXA scans, can help change the trajectory of this disease, sparing millions unnecessary pain, illness and even death. DXA scans are more effective in predicting fractures than cholesterol is in predicting a heart attack or blood pressure in predicting stroke. They are also fast, easy, non-invasive and painless to perform.
Yet there has been a huge drop in scans since 2007, when cuts to the reimbursement for physicians to perform the scans in Medicare Part B, the portion of Medicare that covers things like physician services, outpatient care and preventative services, took effect. Since then, office reimbursements for the tests have dropped by 72% and office-based DXA providers have decreased by more than 50%. Nationally, these Medicare cuts led to hundreds of thousands fewer tests being performed between 2007 and 2009 alone.
One outcome of this has been the reversal of a decade-and-a-half-long decline in hip fractures among postmenopausal women in this country. Here in Maine, 54% of osteoporosis cases went undiagnosed and untreated in 2017, leading to more than 32,000 fewer women receiving a DXA scan than projected in 2008, 40 additional hip fractures because of reduced screening; 88 additional hip fracture-related deaths, and $17 million in additional Medicare costs.
Also, osteoporosis-related bone breaks among Medicare beneficiaries are expensive, costing $57 billion in 2018, with that number expected to grow to over $95 billion in 2040 without reforms, as the population ages.
For years, Sen. Susan Collins has been outspoken about this public health crisis, and she is now the lead sponsor of the Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2021. This bipartisan bill was created to increase access to accurate and effective testing, while significantly lowering the costs and consequences resulting from a lack of diagnosis. The necessary tests and treatments have already been developed. The upsides to making them more available, particularly to women, are unequivocal. It is common-sense legislation.
I am proud of Sen. Collins’ leadership in working to protect the health of those of us most vulnerable to osteoporosis and to give us back control of our health. As we have seen in the Grange community, as we age or one spouse passes on, more responsibility, and often physical duties, are placed on the remaining spouse – which increases the chance of an accident.
Increasing access to DXA scans for all Medicare patients, including those of us living in rural America, allows us to take better control of our health. Congress can make this happen by restoring Medicare funding for DXA and passing the Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2021 without delay.
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