a skeletal disorder characterized by bone thinning and deterioration
with subsequent fractures, is a medical and socioeconomic threat to the
United States' aging population.
Hip fractures increased in the United States since 2012 following a
reduction in the reimbursement rates for dual-energy X-ray
absorptiometry scans, which led to fewer DXA scans being administered to
diagnose osteoporosis and estimate fracture risks in patients.
‘Medicaid announced that the new reimbursement rate for 2017 will be $112.69 for DXA scanners in hospital facilities.’
Sarah Morgan, medical director for the University of Alabama at Birmingham, Osteoporosis Prevention and Treatment Clinic and UAB DXA Facility,
was one of two physicians in a group of patient advocates and
individuals from the International Society for Clinical Densitometry,
the National Osteoporosis Foundation, the American Society of Bone and
Mineral Research, and the American Association of Clinical
Endocrinologists who visited Washington, D.C., in September to lobby the
U.S. Centers for Medicare and Medicaid Services for better DXA payment
on the grounds that a proposed payment reduction could impair access to
this valuable preventive service.
"A DXA scan is a better
predictor of a fracture than a cholesterol level is of a future heart
attack or stroke," said Morgan, a certified clinical densitometrist at
UAB. "In the past few years, Medicare has been lowering reimbursement
for DXA scans to a point that has been below the cost to perform the
test. In turn, there are fewer DXA machines, patients are receiving
fewer DXA scans, and we are seeing a significant increase in hip
In November, Medicaid announced that, instead of the
proposed cut from $100.69 to $63.33 for DXA reimbursement, the new
reimbursement rate for 2017 will be $112.69 for DXA scanners in hospital
"This is an important victory for bone health," said
Morgan, who represented the International Society for Clinical
Densitometry as a past president. "There are fewer operational DXA
scanners in hospitals and clinics. Among the scanners that remain,
people have not always wanted to update them due to the poor
UAB is one of 44 hospitals nationally with an
International Society of Clinical Densitometry-accredited DXA facility,
which assures that quality DXA scans are performed. The UAB Osteoporosis
Prevention and Treatment Clinic is a multidisciplinary clinic that has
nurses, dietitians, physical therapists and physicians working together
to improve skeletal health. A patient education class is held each
Wednesday from 11 a.m.-1 p.m. at The Kirklin Clinic. DXA scans are also available at UAB Medicine Leeds.
Recently, Morgan and fellow researchers published guidelines for quality DXA scanning in the Journal of Clinical Densitometry
outlining best practices related to DXA scan acquisition, analysis and interpretation and reporting of DXA scans.
"The UAB DXA facility fully follows all of these recommendations for quality DXA scanning," Morgan said.