Osteoporosis is a preventable condition, but reducing fracture risk depends on consistent monitoring and timely intervention. For women ages 67–85, a fracture often signals underlying bone loss and creates an opportunity to evaluate and manage osteoporosis.
USPSTF screening guidelines supports the appropriate use of bone mineral density (DEXA) scans and pharmacologic treatment when indicated. These actions also align with the Osteoporosis Management in Women (OMW) with a Fracture HEDIS® measure, which contributes to Medicare Advantage Star Ratings.
OMW measure requirements
The OMW measure applies to:
- Women ages 67–85 who have experienced a fracture*
To meet the measure, patients must have one of the following:
- Bone Mineral Density (BMD) testing
- Within 6 months after the fracture, OR
- Within 2 years (730 days) before the fracture
- Osteoporosis pharmacotherapy (e.g., bisphosphonates)
- Within 6 months after the fracture, OR
- Within 1 year before the fracture
*Fractures of the finger, toe, face, or skull are excluded.
Beyond initial diagnosis: monitoring for change
Post-fracture care may include not only diagnosis and treatment but also ongoing assessment. One component that can be incorporated into management is evaluation of Least Significant Change (LSC).
Establish a baseline
BMD testing soon after a fracture provides a reference point for tracking bone density over time.
Assess treatment response
LSC—typically 3–6%, depending on the facility—represents the minimum change in bone density needed to distinguish a true change from measurement variability. Using LSC can help:
- Evaluate whether therapy is effective
- Identify continued bone loss
- Inform potential adjustments to treatment
Follow-up care gap
Current data indicates that fewer than 20% of fracture patients receive follow-up BMD testing.
This is notable given that the risk of a subsequent fracture is highest within 12–24 months after an initial event. Without evaluation and management, patients may remain at increased risk for repeat fractures and related complications.
Clinical considerations
Approaches that may support post-fracture osteoporosis management include:
- Scheduling a DEXA scan for eligible postmenopausal patients after a qualifying fracture
- Assessing the need for osteoporosis pharmacotherapy based on clinical guidelines
- Using LSC, when available, to monitor response to treatment
- Ensuring follow-up within recommended timeframes, including the first 6 months post-fracture
In summary
A fracture can serve as an opportunity for identifying and managing osteoporosis. Consistent follow-up, including BMD testing and appropriate treatment, supports both patient care and alignment with OMW measure requirements. Integrating these steps into routine workflows can help reduce the likelihood of subsequent fractures and improve continuity of care.
Patient resource: Osteoporosis: what you should know
