Here's Where We Fail (and Succeed) in Osteoporosis Care

September 18, 2020

Today, we talk with Dr. Sarah French, a rheumatologist with the University of California at San Francisco. Dr. French recently published a review in Current Osteoporosis Reports that addresses successes and failures in quality improvement initiatives in osteoporosis. Through the MIPS program, healthcare providers are required to select six quality measures. And while they may be performing well on osteoporosis screenings, their track record on osteoporosis management isn't fairing as well. Dr. French has identified this as an area for improvement. In this interview, she explains how.


The aim of the review was to summarize performance of osteoporosis quality measures used by Centers for Medicare and Medicaid (CMS) Services for pay-for-performance programs.

The three areas of focus in this review was (1) screening in women 65 and older (2) providing osteoporosis management for women who have had fragility fractures, and (3) looking at fall risk assessment and documenting a care plan for people who have a risk of fall or a history of falls.

The review also examined quality improvement projects and different quality measures. Through the MIPS program, healthcare providers are required to select six quality measures. Population-based studies have suggested that achievements for process measures that are not mandated, are lower than achievement standards for those measures in which reporting is mandated.

While there have been improvements in osteoporosis DEXA screenings and other areas, in the area of osteoporosis management after a fragility fracture (which is the prime time for catching someone at high-risk for a second fracture), there were some notable performance gaps.

Only 40 percent of patients who sustained a fracture received either a bone density test or osteoporosis medication within six months of a fracture.

Plus, the review found that the rates of osteoporosis prescription medications is markedly low anywhere from 15-20 percent in patients who have sustained a fragility fracture, Dr. French said.

Patients are falling through the cracks and Dr. French explains why this may be happening.
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CITATION: S French, S Choden, Gabriela Schmajuk. "Quality Measures and Quality Improvement Initiatives in Osteoporosis—an Update," Current Osteoporosis Reports. December 2019. DOI: 10.1007/s11914-019-00547-5