From the May 2011 issue of HealthCare Business News magazine
“The rules of the CMS are that if you are being monitored for an FDA-approved treatment for osteoporosis, you can have a repeat test in less than 23 months after the first test in order to monitor people,” says Siris. “But whenever we do a one-year follow up during treatment inevitably [the claim] is rejected by the local Medicare carrier, even though we put the proper code in to indicate that is what we’re doing, and we have to go back and give them a lot more information.”
The problem of awareness
Siris states that many physicians do not heed patients’ need for osteoporosis testing and treatment in the same way they monitor risk and treat for heart attack and serious forms of cancer.
“The greatest challenge is still an awareness issue and this is a problem for patients and physicians alike,” says Siris. “People do not appreciate the seriousness of later-life fractures, which not only cost a lot of money to fix and have a significant impact on quality of life, but in the case of hip fracture, it has been associated with higher mortality.”
In fact, there is about a 20 percent increased risk of mortality for osteoporotic patients who have suffered a hip fracture, and statistics from the USPSTF note that more than one-third of men who have suffered a hip facture die within a year.
“This is something not to be taken lightly,” says Siris.
OEMs move to diversify
Both GE Healthcare and Hologic are offering skeletal health systems besides traditional bone densitometers. Their focus is expanding skeletal health to include the greater role of total body composition in disease risk and prevention.
GE’s bone densitometer brand, Lunar, includes the DPX and iDXA series of bone densitometry systems, as well as the Achilles quantitative ultrasound technology, which assesses the risk of fracture with a lightweight, portable device. Ultrasound is currently not used to diagnose osteoporosis or monitor treatment, but it is considered a complementary tool for predicting fracture risk.
“Some advancements in the technology along with the thinking, are really going beyond just looking at bone,” says Stoltenberg. “If you take a look at fracture risk or overall health of an individual, how much lean mass and fat you have is in a lot of cases as important as your bone strength. Having the appropriate amount of lean mass helps with stability and fracture prevention.”
GE also offers an over-the-counter device called InBody, which utilizes bioimpedence technology and sends a harmless electrical pulse through the body to quantify body composition. The manufacturer currently has pilot programs in assisted living facilities where advocacy groups help educate residents about how they can build muscle and reduce risk of fracture.
