HAP’s Award-Winning Program Helps Members Manage Osteoporosis

Bones are living, changing parts of our body. We build them when we’re young. And as we age, they can become thin and weak and break easily.

Your bone health depends on factors such as age, diet, exercise, smoking, heredity and hormonal changes such as menopause. When bone growth doesn’t keep up with bone loss, the condition is called osteoporosis.

Losing money and time

The cost of osteoporosis can be huge. Hip fractures cost the health care industry more than $11 billion each year. That’s about $37,000 per patient. In addition to treatment costs, a fracture can mean time in a hospital, time in a rehab, time away from home, family and work. And, if you’ve had a fracture, you’re much more likely to have another one.

So, in 2017, HAP decided to make sure more of our members get the testing and treatment they need.

Boosting bone health

The test for osteoporosis is called a bone density test. It’s a painless, non-invasive fifteen-minute exam. It’s kind of like a mammogram or an x-ray. Osteoporosis often has no symptoms before a fracture, so you may want to ask your doctor if you need to be tested.

If you have osteoporosis, medications and lifestyle changes can help make your bones stronger. That means if you’ve already had a fracture, you may be able to avoid another one.

Removing barriers

Unfortunately, many people who need testing don’t get it, even after a fracture.

The HAP team started their outreach efforts with a letter and phone calls to the group at greatest risk for fractures, 67- to 85-year-old female members who have already had fractures. The goal was to get them to their primary care doctor for a bone density test.

At first, they ran into some barriers.

Many of these members were in long-term care facilities for fractures and couldn’t get to their PCP. Or they were home-bound and had to rely on family members for a ride. So, HAP partnered with a team of preventive care experts who took the test to the member at home or in a rehab facility.

Some members didn’t believe they might have osteoporosis. They were sure that their fracture was simply due to a fall. Fortunately, our team was committed to educating members and helping them avoid the pain, expense and disruption of another fracture. They helped members through the testing process, from the initial outreach call to setting up a PCP appointment or sending the test to them.

Kirsten Selley, HAP senior management engineer, who was instrumental in building the program, says she gives out her direct number, so members can reach her.

“I have people calling me from two years ago.” says Selley. “They want that personalized touch. We case-manage these members until they get their testing completed. We’re there every step of the way.”

Award-winning results

The result of this personalized service was that the number of these members who either got tested or received medication for osteoporosis jumped from 11 percent to 46 percent.

This incredible success was recognized by The Michigan Association of Health Plans, which presents Pinnacle Awards to health plans for outstanding efforts to improve quality and efficiency of care, lower costs and increase services.

At the 2018 Pinnacle Awards, HAP received an award for helping women raise awareness and prevent a second fracture due to osteoporosis. HAP was also recognized for outstanding work in managing the complex health care needs of premature babies.

Focusing on prevention

Ultimately, it’s best to find out about osteoporosis and treat it before a fracture. We’d like to help members avoid the pain, expense and lost time you may experience with a serious injury. Medicare Advantage members who participate in HAP’s Healthy Living Rewards Program and have not had a fracture can get a $20 gift card for getting a bone density test.