title: Effect of Medicare reimbursement reduction for imaging services on osteoporosis screening rates.
abstract: OBJECTIVE
  To determine bone mineral density (BMD) testing rates and the proportion of women diagnosed after BMD screening vs an osteoporosis-related fracture before and after reductions in Medicare reimbursement for office-based imaging services in 2007, which was projected to save $2.8B over 5 years.
  
  
  METHODS
  Retrospective observational analysis of administrative medical claims reimbursement data.
  
  
  METHODS
  Analysis of data from a medical claims data set.
  
  
  METHODS
  A cohort of 405,093 women (average age 74.1 ± 6.7) aged 65 and older with employer-sponsored Medicare supplemental coverage.
  
  
  METHODS
  BMD testing and the incidence of participants whose first diagnosis for osteoporosis occurred with BMD screening vs as a result of osteoporosis-related fracture were identified by calendar year.
  
  
  RESULTS
  Thirty-eight percent of participants received one or more BMD tests during the study period. The proportion of women who received a BMD test was 12.9% in 2005, 11.4% in 2006, 11.8% in 2007, and 11.6% in 2008. Although testing rates varied, results were consistent with testing guidelines and did not decrease at a rate relative to reimbursement reductions, as had been anticipated.
  
  
  CONCLUSIONS
  BMD screening rates did not substantially decline in Medicare-eligible women in the 2 years after reimbursement reductions. Meanwhile, the proportion of women diagnosed after a fracture increased, although the nature of this increase is unclear.
authors.affiliation: Pharmacotherapy and Pharmacotherapy Outcomes Research Center, University of Utah, Salt Lake City, Utah 84108, USA. carrie.mcadam-marx@pharm.utah.edu
authors.forename: Carrie
authors.initials: C
authors.lastname: McAdam-Marx
authors.forename: Sudhir
authors.initials: S
authors.lastname: Unni
authors.forename: Xiangyang
authors.initials: X
authors.lastname: Ye
authors.forename: Scott
authors.initials: S
authors.lastname: Nelson
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Nickman
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000191:economics*; D006278:Medicare / Q000191:economics*; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging* / Q000191:economics; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014481:United States