Pantagraph.com Weather forecast, local radar and more
NewsMonday, March 17, 2008 9:47 AM CDT
Comments Comments (0) | E-mail this page E-mail this page | Print this page Print this page | Enlarge type Enlarge type | Reduce type Reduce type | Search archives Search archives | RSS RSS feeds | Add to My Yahoo! Add to My Yahoo!
Medicare cuts may limit osteoporosis bone density scans
By Diane C. Lade
South Florida Sun-Sentinel (MCT)
Advertisement

FORT LAUDERDALE, Fla. -- Health experts for years have been trying to get osteoporosis bone density scans on the same public wavelength as mammograms, prostate exams and other routine screenings for older adults.

But now some health advocates fear this work may be undone by severe cutbacks in Medicare payments for these tests now done mostly in doctors’ offices and clinics.

Doctors in South Florida and elsewhere say the Medicare cuts may push them to stop offering those scans, which could limit access for many seniors and others at risk of osteoporosis.

Cuts in Medicare reimbursement for DXA scans — short for dual energy x-ray absorptiometry — began last year. The original $140 Medicare reimbursement for a DXA scan of the hip, pelvis and spine in Broward and Palm Beach counties dropped to $88 this year.

Based on current projections, it’s estimated Medicare will pay only about $50 for an axial DXA scan by 2010.

Payments for DXA scans and other imaging tests were capped as a cost-savings measure under the Deficit Reduction Act that went into effect in 2006, prompting changes in how doctors can bill for radiology services. A bill, HR 4206, has been introduced in Congress to freeze reimbursements for DXA and vertebral facture assessment, or VFA, tests at 2006 levels for two years.

Most doctors and smaller imaging centers probably won’t be able to absorb the cut, according to the National Osteoporosis Foundation, and will stop offering DXA tests. This could mean seniors, especially those in smaller cities, might have less access to the screenings and be less likely to get bone scans.

Dr. Michael Schweitz, of Arthritis and Rheumatology Associates of Palm Beach, Fla., said his group is trying to decide whether they will keep their two DXA scans, one purchased and one leased, if the cuts continue. “It will be hard to pay the maintenance contract on the machines and if we can’t, the machines are going to go,” he said.

The foundation considers the cuts a step backward — especially since federal health officials now recommend all women have a bone scan at age 65, with more frequent tests for patients with a family history or who already have signs of osteoporosis.

Early detection of osteoporosis is the best way, they say, to prevent the debilitating fractures that can lead to costly hospitalizations, immobility and nursing home stays.

The DXA scan, which gives a density “T-score” measure for the hip, wrist and ankle, is the only osteoporosis test Medicare will pay for and is one of the battery of medical screenings recommended for new beneficiaries.

“It’s a bizarre situation. Federal initiatives say you should be tested because its expensive for Medicare to pay for late-in-life fractures. Yet they dramatically cut reimbursements that may lead to limited access to these tests,” said foundation President Dr. Ethel Siris, who directs an osteoporosis treatment program at Columbia University Medical Center in New York City.

Jean Vaughan discovered she had early stage osteoporosis through her first bone scan in 2000 and has had two follow ups tests since.

“It’s important for your health. If you do have thinning bones, you will have some big problems,” said Vaughan, 70. Her older sister, who also has osteoporosis, broke her hip four years ago just by lifting groceries into her car.

Vaughan is in the minority, however, as only about 20 percent of eligible Medicare patients have their bone density measured. An estimated 44 million Americans have low bone mass or osteoporosis, the vast majority developing the condition after age 65. About three-fourths of them are female, which is why the condition usually is viewed as a women’s health issue. But men can have osteoporosis, too.

Medicare paid out about $194.7 million for 2.8 million axial scans in 2006, the most current year numbers are available.

The International Society for Clinical Densitometry estimates about two-thirds of all bone density measurements are done in a doctor’s office or imaging clinic.

Osteoporosis is responsible for more than 1.5 million fractures annually, according to 2004 U.S. Surgeon General’s report on bone health, with an average hip fracture costing $40,000 in medical care. Fractures also are one of the major reasons seniors must go to a nursing home, accounted for 180,000 placements a year, the Surgeon General found.

(c) 2008, South Florida Sun-Sentinel. Distributed by McClatchy-Tribune Information Services.

Video
Most commented stories
Browse online archives
Recent issues:
Reader comments on this story - 0 total

Note: All views and opinions expressed in reader comments are solely those of the individual submitting the comment, and not those of the Pantagraph or its staff.
Add your own comments

Please read the rules before posting comments.

You must be logged in to leave comments.
If you don't have a member ID, please register.

*Member ID:
*Password:
Remember login?
(requires cookies)
  Forgot Your Password?
 
Lee Enterprises Customer Service | 301 W. Washington St., PO Box 2907, Bloomington, IL 61701-2907 | Ph. 309-829-9000 | 800-747-7323
Copyright © 2008, Pantagraph Publishing Co. and Lee Enterprises. All rights reserved. | Terms of Use | Privacy Policy