Transforming Osteoporosis Bone Health (OBH) in the U.S.

Five Pillars for OBH Practice Success

Osteoporosis Bone Health (OBH) in the U.S. is undergoing a significant disruption. The traditional focus on postmenopausal osteoporosis and post-fracture care is expanding into a broader role, emphasizing fracture prevention and orthopedic surgery risk mitigation. OBH is now pivotal to reducing fracture risks, optimizing healthcare resources, and driving cost efficiencies in societal healthcare.

Addressing Emerging Challenges 

The evolving OBH landscape presents new challenges, including: 

  • Reducing societal healthcare costs through effective fracture risk management. 

  • Maximizing enterprise-level efficiency, such as staffing, inpatient bed utilization, and operating room time. 

  • Adapting to new practice settings while ensuring financial sustainability. 

Meeting these challenges requires strategic resource deployment and innovative approaches to building and expanding OBH service lines. 

A Blueprint for Success: Common Traits of Leading OBH Practices 

Through extensive analysis, we’ve identified five key pillars of success shared by high performing OBH programs, offering a replicable framework for integrating advanced technologies, accommodating higher patient volumes, and scaling service lines of any size in a systematic, step-by-step manner. 

A Commitment to the Future of OBH 

Guided by these pillars, OBH programs can navigate the evolving landscape with confidence, driving impactful results in fracture prevention, patient engagement, and operational efficiency. The tools and insights provided reflect our ongoing dedication to enabling enterprises to meet growing demands while maintaining revenue-positive outcomes. 

The American Society of Osteoporosis Providers (ASOP)

Board of Directors

Rethinking Osteoporosis Bone Health (OBH) Care: A Path to 21st-Century Success

Over the past 30 years, significant efforts have been dedicated to educating providers and setting goals in U.S. osteoporosis bone health (OBH) care. Despite these efforts, the system has become ossified, often hindering progress at the patient level. To achieve meaningful advancements, we must shift from a medical practice model to a comprehensive healthcare business model.

A strategic vision and goal-setting are crucial for transitioning the current fee-for-service model to one centered on value-based care. This transition must prioritize measurable outcomes, such as reducing fractures and lowering societal healthcare costs. The Five Pillars of Success, championed by the American Society of Osteoporosis Providers (ASOP), provides a framework to shift the focus from simply measuring T-scores to assessing fracture and complication risks—and reducing those risks in a sustainable, repeatable way.

The Five Pillars of Success

1. Patient Identification

The system's foundation is identifying patients for OBH care. This involves leveraging tools such as population health analytics, electronic health record (EHR) queries, AI-driven radiographic fracture risk assessments, and screening programs for primary and secondary osteoporosis. Specific patient populations, such as preoperative orthopedic patients (e.g., spine and total joint patients), present key opportunities for intervention.

Each identification method requires unique processes but ultimately converges on a common goal: engaging patients in OBH care. A significant challenge remains the shortage of providers equipped to care for the identified patients.

2. Enterprise and Professional Education

Education in OBH has not kept pace with advances in the field. Providers often receive minimal training based on outdated knowledge from decades ago, leading to unrealistic expectations and program failures. For example, healthcare executives may struggle to predict the return on investment for an OBH program, understand revenue streams, or assess staffing needs.

ASOP has developed an enterprise-wide return-on-investment (ROI) calculator to address these gaps. This tool helps organizations evaluate patient volumes, revenue potential, staffing requirements, and fracture reduction outcomes. Certification-level training for basic and advanced healthcare providers is also under development, offering standardized education that ensures sustainability and scalability for OBH care.

3. Patient Engagement

Engaging patients is critical to OBH's success and represents the midpoint of their care journey. Providers must be skilled and confident in OBH, capable of interpreting tests, assessing risks, and formulating treatment plans. They should clearly communicate the importance of risk reduction for enhancing quality of life, just as they would for other chronic conditions.

Providers act as quality control checkpoints, ensuring accuracy in OBH screening protocols, bone density testing, lab assessments, and treatment plans. Their expertise should enable them to guide the engagement process effectively, though administrative tasks like insurance authorizations are handled by support staff.

4. Patient and Staff Retention

Retaining both patients and staff is vital for a successful OBH program. Patients who feel well cared for are more likely to stay engaged long-term, while providers who feel valued and supported are more likely to remain in their roles. Stability in staffing leads to better patient satisfaction, ultimately enhancing retention rates for both groups.

Strategic planning for staffing ensures the enterprise can meet future OBH demands, contributing to operational success and improved patient outcomes.

 

5. Enterprise Success Matrix

An effective OBH program requires a clear enterprise success matrix to guide growth and sustainability. This includes modeling financial success, setting realistic goals, and optimizing resource utilization.

The positive impacts of OBH extend across multiple stakeholders:

- Patients experience improved quality of life through reduced fracture risk.

- Healthcare providers benefit from professional recognition, standardized training, and access to better resources.

- Enterprises achieve value-based care goals, generate revenue, and improve public and patient relations.

- Society realizes cost savings from reduced fractures and surgical risks.

 

A New Future for Osteoporosis Bone Health

By adopting the Five Pillars of Success, OBH care can evolve to effectively address fracture risk and prevention. This roadmap integrates professional organizations, governmental and private resources, and innovative technologies to achieve shared goals. The goal is to move from asking, "What is your T-score?" to "What is your fracture/complication risk, and how can we reduce it?" in a sustainable and impactful way. Together, we can transform osteoporosis care for a better future.