This report appeared in the May 2010 issue of DOTmed Business News
In the United States, osteoporosis is the direct cause of more than 500,000 hospital admissions, 2.6 million physician visits and nearly 180,000 nursing home admissions. The International Society for Clinical Densitometry (ISCD) reports that the numbers are expected to increase in the years ahead, with at least 3 million new fractures expected to occur annually by 2025.
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Bone density scanning, also called dual-energy X-ray absorptiometry (DXA) or bone densitometry, is an enhanced form of X-ray technology used to measure bone loss. It's important to identify bone loss because there are medicines and treatments that can help combat the problem and the earlier it's caught, the better the likelihood of effective treatment. Unfortunately, not enough people undergo the testing.
"It's a point-of-care issue and making the testing available to the patient," says Tony Orlando, president of Michigan-based Complete Medical Services, Inc. "A lot of people have never been tested for osteoporosis and many of them have very severe osteoporosis, so if they fall, it takes nothing for a serious injury to occur."
The trouble is, reimbursement rates for this sector have fallen a great deal since 2006. That means from a financial perspective, many physicians can't justify doing the scans themselves and instead, refer patients to hospitals.
"As an industry, we have seen significant decline over the last few years, largely because reimbursement has decreased significantly," says Jim Wolf national sales manager for the Lunar Division of GE Healthcare. "In 2006, it was in the mid-$130 range. This year, we were in the mid $50-$60 and what we have seen is the market for products as a whole has declined."
Orlando agrees and points to the fact that the decreases have resulted in fewer people getting the care they need.
"Every year for the last four years, reimbursement has been getting hammered for bone density. That has made it next to impossible for a small practice to offer DXA scans to their patients," Orlando says. "With bone density, there's really no sense of urgency for the patient. They don't see the need to get the test done right away and they put it off."
But due to portions of President Obama's health care bill, all that may be changing. A provision in the health care package will help with the reimbursement challenges that have plagued the industry.
"Right now, the big buzz is in the health care bill. There was a small section that was related to density reimbursement, which would restore reimbursement up to $98 on national average when the service is performed in a physician office or physician-owned imaging center," says John Jenkins, senior director skeletal health division for Hologic, Inc. "The private practice sector has been declining over several years, so this is a really big development."
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