This article series is a monthly tool to help physicians maximize patient health outcomes in accordance withNCQA's* HEDIS^®† measurements for high quality care on important dimensions of services.Go to our website to view previously published Highlighting HEDIS^® topics.If you have feedback or would like to request a topic, email us.

HEDIS^® definition

Osteoporosis management in women who had a fracture: The percentage of women ages 67 – 85 who suffered a fracture and who had either a bone mineral density (BMD) test or prescription for a drug to treat osteoporosis in the six months after the fracture.

National average

The chart below displays the national average for HMO and PPO performance in this measure from 2009 – 2013.

Why this measure is important

This measure assesses how well the organization manages women who are at high risk for a second fracture. It studies whether female members who suffered a fracture had evidence of either a BMD test or prescription for a drug to treat osteoporosis in the six months after the fracture date.

Morbidity and mortality related to osteoporotic fractures are major health issues. Ten million Americans have osteoporosis, and another 18 million are at risk due to low bone mass. Eighty percent of people with osteoporosis are women. Women who suffer a fracture are at increased risk of suffering additional injuries.

Treatment of osteoporotic fractures is estimated at $10 – $15 billion annually in the U.S. The aging U.S. population is likely to increase the future financial cost of osteoporosis care.? NCQA, HEDIS 2015 V1

New incentive opportunity

Independence is offering an incentive opportunity through a new program for Medicare Advantage HMO and PPO members who have been identified to be at-risk for osteoporosis to receive a BMD test. We will mail a list of identified members to affected providers, and incentives can be earned if the member:

• receives a DEXA scan at the provider's capitated (HMO) or any in-network (PPO) radiology site;
• receives a quantitative ultrasound BMD study in his or her home through Mobile Medical Examination Services, Inc. (MedXM), an independent company.

QIPS^‡ and Stars^§ alert

Osteoporosis management in women who had a fracture is a performance measure in the Quality Incentive Payment System (QIPS) program for measurement year 2015 for participating providers and is also a Medicare Stars measure.

^* The National Committee for Quality Assurance (NCQA) is the most widely recognized accreditation program in the U.S.

^† The Healthcare Effectiveness Data and Information Set (HEDIS^®) is an NCQA tool used by more than 90 percent of U.S. health plans to measure performance on important dimensions of care.

^‡ QIPS is a reimbursement system developed by Keystone Health Plan East for participating Pennsylvania primary care physicians that offers incentives for high-quality, accessible, and cost-effective care.

^§ Stars is a program developed by the Centers for Medicare & Medicaid Services to measure quality health care. Ratings are published annually to help educate consumers prior to enrollment decisions.

HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). Used with permission.