Secondary Fracture Prevention Initiative

As part of NBHA’s “20/20” vision to reduce bone breaks 20% by the year 2020, NBHA is pursuing widespread implementation of a Fracture Liaison Service (FLS) model of care in a number of health care settings, including Medicare, managed care, large hospitals systems and private payers. FLS programs coordinate post-fracture care through an FLS coordinator (a nurse or other allied health professional) who ensures that individuals who suffer a fracture receive appropriate diagnosis, treatment and support.

FLS programs have been successful in a number of closed and open settings, both in the U.S. and internationally. These programs have greatly reduced the number of costly and serious recurrent fractures by identifying and appropriately treating post-fracture patients, recognizing that this group is comprised of those at highest risk of future fractures.

NBHA is using the following U.S. programs as models for this initiative:

• Kaiser Permanente’s Healthy Bones program, which has led to an overall 38% reduction in the expected hip fracture rate since 1998.
• Geisinger Health System osteoporosis disease management program, which achieved $7.8 million in cost savings over 5 years.
• American Orthopaedic Association’s Own the Bone program, a voluntary FLS program designed to address the osteoporosis treatment gap and prevent subsequent fractures. Own the Bone has also achieved change in clinician behavior and improved patient treatment and referral in the open system.

NBHA is leveraging the expertise of these model programs in addition to the National Osteoporosis Foundation’s expertise in patient and health care professional education and training and the American Society for Bone and Mineral Research Task Force Report on Secondary Fracture Prevention.

Internationally, NBHA is collaborating with groups such as the International Osteoporosis Foundation Capture the Fracture initiative and the Fragility Fracture Network.