New tools to help you close osteoporosis care gaps
One of the most challenging care gaps for payers to close is osteoporosis management in women (OMW) with a fracture.
The target group is relatively small—only women 67-85 years of age who suffered a fracture. And instead of a year to close the gap, the measure stipulates a bone mineral density (BMD) test must occur or a prescription be written within six months of the fracture. Additionally, the fracture may be diagnosed during an ER visit that the PCP may be unaware of. If the PCP is not made aware, follow-up care could be missed.
That said, this is an important measure to close. It’s a challenging measure for payers but can be an area of opportunity to help improve Star ratings. And it’s valuable for your members. Osteoporotic fractures are associated with chronic pain and disability, loss of independence, decreased quality of life and increased mortality. Appropriate screening and treatment can reduce the risk of osteoporosis-related fractures.
Vatica partnered with health plan clients in New York state to help PCPs close this gap. These two plans provided a file of open care gaps for Vatica to combine with medical record data and more accurately identify patients who meet the measure criteria. This information from the plan is vetted by a Vatica clinical consultant and, if determined to be a persistent gap, escalated to the PCP via Vatica’s application when these patients come for a visit.
Vatica makes it simple for the PCP to verify that no exclusions apply and to follow up with either the BMD test or medication.
This new product feature was introduced in March for PCPs who are part of these payers’ networks. We already see an increase in OMW gap closure.
For questions and more information, please contact your Vatica client engagement representative.