Bone density testing can profit your program
Bone density testing can profit your program
Screening pays for itself, cuts future medical costs
It’s not a hard sell women are hungry for information about bone health. Once they learn they can prevent or treat osteoporosis, your bone density testing and bone health program will flourish, say women’s health managers who offer such a program.
And that’s not all: A quality bone health program is relatively easy to design, cost-effective, and profitable, they say.
Women are aware of the value of bone density testing, says Gwen Gustavson, RN, manager of women’s services at the Gwinnett Women’s Pavilion of the Promina Health System in Lawrenceville, GA. She says the local news media have run segments on osteoporosis. The Women’s Pavilion also reinforces awareness by including bone health handouts in the health education packets for its programs on breast health and menopause.
"We’re seeing an increased quest for knowledge about osteoporosis," Gustavson says. "When you can educate women about the risks of something that will lead to fractures and possible immobilization in later life, they begin to see the significance of the issue."
That education generates readiness to use bone density measurement services, Gustavson says.
Some women are anxious enough to learn about their bone health status that they pay the $145 to $200 testing fees out of pocket. Insurance coverage of bone density measurement is spotty, says Benta Cooney, MSW, director of public policy at the National Osteoporosis Foundation in Washington, DC. Cooney says that Medicare pays for tests when they are used to diagnose osteoporosis. However, she notes, the amount of Medicare payment isn’t standardized, even though Medicare is a federal program
"We are working with Congress to standardize Medicare coverage from state to state," she says.
Costs of measurement programs
The bone scanner represents the major investment for a bone health program.
"Compared to other equipment, bone scanners are not that expensive," says Joyce Pierce, manager of WomanCare of St. Joseph Hospital in Houston, TX. WomanCare has offered testing since 1987 and recently spent $60,000 to replace its old scanner. According to Pierce, that’s about midrange in today’s market. She pays her part-time technician $16 an hour.
Test quality hinges on the technician’s skill and experience, Pierce emphasizes.
"The person should have a background in X-ray." she suggests. And here’s the reason: A patient recently came to WomanCare with an undiagnosed bone disease in her right hip, the side usually scanned for density.
"The technician picked that up right away and scanned the left hip instead," Pierce says. Additionally, the technician notified the patient’s physician about the problem with the right hip and ensured that it got the attention it needed.
Had the patient gone to an office where the receptionist was running the equipment, the additional bone disease might have gone undetected, she says.
Technicians must know how to produce bone scan reports that physicians can comprehend. Since physicians prescribe bone strengthening medications on the basis of the data, Pierce says, "technicians have to be able to go the first step in interpreting the data by providing a user-friendly bone scan report." (For information on designing an exercise program for women with osteoporosis, see Women’s Health Center Management, April 1997, pp. 51 and 53, and at-a-glance descriptions of osteoporosis exercises in the same issue, p. 52.)
Gustavson credits the success of her osteoporosis service to a strong educational push. Using a dine-and-learn approach in the Women’s Pavilion conference room, she offers free lunches or breakfasts featuring area radiologists, OB/GYNs, or rheumatologists as invited speakers. (For sample bone health education handouts, see inserts in this issue.)
Sometimes the center offers a limited number of reduced-cost bone density tests for program attendees. Typically, the programs draw 60 participants.
To advertise, Gustavson puts notices in the hospital’s quarterly newsletter, which is mass mailed throughout the community. During the three weeks before each event, she places two ads a week in the local newspaper. One appears on a weekday, the other on Saturday. Extra exposure comes from handouts and laminated posters in the participating physicians’ offices.
Eager for the self-marketing opportunity, the physicians don’t charge for their time, Gustavson says. "It’s a win-win situation for them and for us," she says. "We always give them a small token of appreciation, like a fruit basket."
Besides targeting the community, Gustavson holds breakfasts for the hospital’s female employees and volunteers. Like most communities, Lawrenceville has Mall Walkers, women and men who regularly take fitness walks through the shopping malls, usually before business hours.
"Because these individuals are getting older and beginning to take more interest in preventing fractures, we present programs for them," Gustavson explains.
Mall Walkers’ programs take place at local shopping malls in the mornings when participants assemble for their regular walks. A typical group numbers 20 men and women. Gustavson reaches the walkers through the same market strategies she uses for the on-site offerings.
The payoffs for education programs more than offset the staff time and $1 to $4 luncheon or breakfast costs, Gustavson observes. Since the program started in mid-1995, the test volume has grown to 70 a month, and it continues to grow.
"At budget time, we’ve asked ourselves whether we really need another free program on osteoporosis, but when we see the increase in test utilization and the results in hard dollars, we say, It’s worth it,’" Gustavson says. A lot of facilities have scaled down their patient education because of the expense, but in this area, it increases profits." ß
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