Osteoporosis care in the United States after declines in reimbursements for DXA

Burton L. Hayes, Jeffrey R. Curtis, Andrew Laster, Kenneth Saag, S. Bobo Tanner, Caiqin Liu, Catherine Womack, Karen Johnson, Fazila Khaliq, Laura D. Carbone

Research output: Contribution to journalArticle

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Abstract

In January 2007, in the United States (US), Medicare initiated a series of cuts to reimbursement for dual-energy X-ray absorptiometry (DXA) services performed in the nonfacility setting that by January 2010 reduced payments for these services by more than 60% compared with 2006 levels. The objectives of this study were to determine if a temporal association exists between Medicare Physician Fee Schedule changes in office-based DXA reimbursement and attendance at educational conferences for osteoporosis, physicians' perceptions of changes in their medical practices, or national trends in retail prescription medications for osteoporosis in those aged 65 and older.Compared with the 2. yr before the decline in Medicare reimbursement for DXA (2005-2006), attendance at educational meetings for osteoporosis in the US declined in the 2. yr after these cuts (2007-2008) by 6%; declines in attendance were only present in meetings selective for bone densitometry. Survey participants reported changes in DXA services with approximately one-third indicating that they had either decreased the number of DXAs they performed or declined service contracts or hardware/software updates compared with 2005-2006. The number of retail prescriptions for Food and Drug Administration-approved osteoporosis drugs (excluding estrogen compounds and raloxifene) in the age 65 and older population increased by 5.5% in the time period 2007-2008 compared with 2005-2006. However, in the last year of the study (2008), total retail prescriptions for these drugs experienced for the first time over the interval of the study, a decline (1.4%) compared with the previous year. This occurred despite a 2.6% increase in the US population age 65 and older.In conclusion, there were temporal associations noted between Medicare cuts in DXA payments in attendance at educational conferences for bone densitometry, self-report of office-based provision of DXA services in the US, and retail prescriptions for osteoporosis therapies.

Original languageEnglish (US)
Pages (from-to)352-360
Number of pages9
JournalJournal of Clinical Densitometry
Volume13
Issue number4
DOIs
StatePublished - Oct 1 2010

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Photon Absorptiometry
Osteoporosis
Medicare
Prescription Drugs
Densitometry
Prescriptions
Contract Services
Fee Schedules
Physicians
Bone and Bones
United States Food and Drug Administration
Self Report
Population
Estrogens
Software
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Hayes, B. L., Curtis, J. R., Laster, A., Saag, K., Tanner, S. B., Liu, C., ... Carbone, L. D. (2010). Osteoporosis care in the United States after declines in reimbursements for DXA. Journal of Clinical Densitometry, 13(4), 352-360. https://doi.org/10.1016/j.jocd.2010.08.001

Osteoporosis care in the United States after declines in reimbursements for DXA. / Hayes, Burton L.; Curtis, Jeffrey R.; Laster, Andrew; Saag, Kenneth; Tanner, S. Bobo; Liu, Caiqin; Womack, Catherine; Johnson, Karen; Khaliq, Fazila; Carbone, Laura D.

In: Journal of Clinical Densitometry, Vol. 13, No. 4, 01.10.2010, p. 352-360.

Research output: Contribution to journalArticle

Hayes, BL, Curtis, JR, Laster, A, Saag, K, Tanner, SB, Liu, C, Womack, C, Johnson, K, Khaliq, F & Carbone, LD 2010, 'Osteoporosis care in the United States after declines in reimbursements for DXA', Journal of Clinical Densitometry, vol. 13, no. 4, pp. 352-360. https://doi.org/10.1016/j.jocd.2010.08.001
Hayes, Burton L. ; Curtis, Jeffrey R. ; Laster, Andrew ; Saag, Kenneth ; Tanner, S. Bobo ; Liu, Caiqin ; Womack, Catherine ; Johnson, Karen ; Khaliq, Fazila ; Carbone, Laura D. / Osteoporosis care in the United States after declines in reimbursements for DXA. In: Journal of Clinical Densitometry. 2010 ; Vol. 13, No. 4. pp. 352-360.
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abstract = "In January 2007, in the United States (US), Medicare initiated a series of cuts to reimbursement for dual-energy X-ray absorptiometry (DXA) services performed in the nonfacility setting that by January 2010 reduced payments for these services by more than 60{\%} compared with 2006 levels. The objectives of this study were to determine if a temporal association exists between Medicare Physician Fee Schedule changes in office-based DXA reimbursement and attendance at educational conferences for osteoporosis, physicians' perceptions of changes in their medical practices, or national trends in retail prescription medications for osteoporosis in those aged 65 and older.Compared with the 2. yr before the decline in Medicare reimbursement for DXA (2005-2006), attendance at educational meetings for osteoporosis in the US declined in the 2. yr after these cuts (2007-2008) by 6{\%}; declines in attendance were only present in meetings selective for bone densitometry. Survey participants reported changes in DXA services with approximately one-third indicating that they had either decreased the number of DXAs they performed or declined service contracts or hardware/software updates compared with 2005-2006. The number of retail prescriptions for Food and Drug Administration-approved osteoporosis drugs (excluding estrogen compounds and raloxifene) in the age 65 and older population increased by 5.5{\%} in the time period 2007-2008 compared with 2005-2006. However, in the last year of the study (2008), total retail prescriptions for these drugs experienced for the first time over the interval of the study, a decline (1.4{\%}) compared with the previous year. This occurred despite a 2.6{\%} increase in the US population age 65 and older.In conclusion, there were temporal associations noted between Medicare cuts in DXA payments in attendance at educational conferences for bone densitometry, self-report of office-based provision of DXA services in the US, and retail prescriptions for osteoporosis therapies.",
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