Member Spotlight: Improving Bone Health in the U.S.

By: Claire Gill, CEO, Bone Health and Osteoporosis Foundation

Osteoporosis is a serious chronic condition that weakens bones over time, significantly increasing fracture risk. It is estimated that 54 million Americans have osteoporosis and low bone mass, and the disease is responsible for approximately two million broken bones each year in the United States.

During the COVID-19 shutdown, the National Osteoporosis Foundation (NOF) began a brand review process that would last 16 months. In October 2021, the organization announced its rebranding to the Bone Health and Osteoporosis Foundation (BHOF). The change highlights feedback from clinicians, patients, caregivers, and the general public that the organization should focus on bone health and prevention as much as it does on osteoporosis diagnosis and treatment.

The new brand, along with its tagline, “Healthy Bones, Build Them for Life,” is a call to action to improve bone health and strength at every stage of life to avoid the debilitating and life-changing fractures that can occur due to osteoporosis. Bone is living tissue that recycles and rebuilds throughout the lifespan. In childhood and young adulthood, a healthy diet rich in calcium and vitamin D and weight-bearing and muscle-strengthening exercises help to achieve what is known as “peak bone mass” – the strongest and most dense bone the body can make. As we age, the focus should shift more towards maintaining bone density to prevent the development of osteoporosis. Lifestyle factors including nutrition and exercise continue to play a critical role in maintaining bone health.

According to a new report that BHOF commissioned from the independent actuarial firm Milliman in 2021, the total annual cost for osteoporotic fractures among Medicare beneficiaries was $57 billion in 2018 and without reforms is expected to grow to over $95 billion in 2040, as our population ages.

The good news is that we have the tools to stem this crisis. We just need to make sure people know about them and use them. Medicare pays for high-quality bone density testing to identify those who are at risk of bone fractures, allowing for early and effective preventive interventions. However, only eight percent of women who suffer a fracture are screened for osteoporosis.  For Black women on Medicare, the screening rate is just four percent. Medicare also pays for FDA-approved drug treatments for osteoporosis that can help reduce spine and hip fractures by up to 70 percent and cut secondary (repeat) fractures by about half. But about 80 percent go untreated, even after a fracture.

Leading health systems like Geisinger and Kaiser Permanente have successfully reduced repeat fractures and lowered costs by employing new models of coordinated post-fracture care. But most of those with fractures go without this cost-effective help because Medicare doesn’t incentivize its use.

Not only would better use of these proven steps prevent more of the 2.1 million annual osteoporotic fractures and the early death and suffering they cause, but money would also be saved. The Milliman report concludes that reducing just 20 percent of secondary (repeat) osteoporotic fractures could reduce Medicare spending by over $1 billion over up to 2 to 3 years.

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The Bone Health and Osteoporosis Foundation is a member of the National Health Council. For more information about membership, contact