Starting in 2021, Priority Health is expanding outreach to providers who have Medicare patients with a gap in care related to osteoporosis management in women (OMW). These are patients who have been identified as needing a DXA bone density scan, due to experiencing a recent fracture.

What’s changing?

Today, Priority Health sends a single fax notification when a patient meets both The Centers for Medicare and Medicaid Services (CMS) and National Committee for Quality Assurance (NCQA) recommendation for a DXA bone density test within six months of most types of bone fractures in women age 67 -85. The fax asks you to schedule a screening or treatment within six months of the member experiencing the fracture.

Starting in 2021, they’ll follow-up with reminder faxes to the provider on a monthly cadence until the screening has been scheduled. In addition to the initial notification, you could receive six follow up faxes per event (one per month, for six months) reminding you to schedule the screening.

Why are they making this change?

The plan wants to partner with you to reduce osteoporosis-related fractures so members and your patients can continue to be their healthiest.

Tips for improving osteoporosis management:

• Place an order for a DXA bone density test, and follow up to ensure the patient completes it
• For patients with upcoming visits, add appointment notes to address the fracture
• Schedule a follow-up appointment for discussion, if you’ve not done so already
• Assess the patient’s risk of falling, and increase communication with patients about their risk of fracture

Click here to view the sample reminder that will be sent out by Priority Health.