December 2019

Osteoporosis Management in Women Who Had a Fracture Remains Low

Osteoporotic fractures can reduce patient quality of life, increase morbidity and mortality and lead to higher health care costs. Women 65-85 years of age who have suffered a fracture are at a significantly higher risk for developing additional fractures.¹ Therefore, osteoporosis management in these women is critical to prevent future fractures.

The recommended treatment is for women to have a bone mineral density test or osteoporosis treatment within six months after a fracture.

According to the National Committee for Quality Assurance (NCQA), osteoporosis testing and treatment among patients who are at risk and those who have already suffered a fracture remains low despite the availability of effective treatments.²

What can you do to help ensure optimal management of these patients?

• Schedule fracture patients for a bone mineral density test or prescribe an osteoporosis medication within 180 days of the fracture.
• Annually test women age 65 to 85 that are at risk with a bone mineral density test to prevent fractures and the development of osteoporosis.
• Promote and ensure patient compliance with osteoporosis medications by ensuring patients are filling their prescriptions.
• Talk to patients about eating a healthy diet that includes adequate calcium and vitamin D, smoking cessation, limiting alcohol use and performing regular weight-bearing exercises if appropriate.

Below is the list of medications provided on the Healthcare Effectiveness Data and Information Set (HEDIS^®) technical specifications for the measure Osteoporosis Management in Women with Fracture:

Remember to check formularies for drugs covered by the member’s plan. Also ask to see the member's ID card for current information and a photo ID to help guard against medical identity theft.

¹Centers for Disease Control and Prevention (CDC), Does Osteoporosis Run in Your Family? July 5, 2019. https://www.cdc.gov/genomics/disease/osteoporosis.htm?CDC_AA_refVal=https://www.cdc.gov/features/osteoporosis/index.html.

²NCQA, Osteoporosis Testing and Management in Older Women. 2019. https://www.ncqa.org/hedis/measures/osteoporosis-testing-and-management-in-older-women/

HEDIS is a registered trademark of NCQA.

The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. References to third party sources or organizations are not a representation, warranty or endorsement of such organizations. Any questions regarding those organizations should be addressed to them directly. The fact that a service or treatment, or the listing of any particular drug or classification of drugs, is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.