New reports coming to help close osteoporosis care gaps

To help improve health outcomes and support gap closure in the Osteoporosis Management for Women Who Had a Fracture (OMW) HEDIS measure, our Medicare Quality team has compiled a list of patients who are still in need of testing and or therapies to help manage osteoporosis. We’ll be sending you these reports monthly so you can distribute them to impacted providers.

OMW gap closure

To close OMW care gaps, providers must either have their applicable patients complete a bone mineral density (BMD) test or prescribe them a drug to help treat osteoporosis. Note: To close this care gap with an osteoporosis medication, members must process their prescription using their Priority Health Part D coverage. Processing a prescription using pharmacy discount programs or manufacturers’ coupons won’t count toward gap closure. For information on our covered osteoporosis drugs, visit our Medicare approved drug list.

Provider tips for closing OMW care gaps:

• Educate your patient on where/how to schedule their BMD test and emphasize the importance of completing the test within the six-month window. Does your patient need help getting to appointments? Our Medicare Advantage members are eligible for transportation assistance through the Papa pals program.
• Ensure your documentation is accurate and complete. Check out our OMW HEDIS measure spotlight for information on coding requirements for this measure.
• Encourage your patients to alert you if they suffer a fracture to allow for timely intervention and testing. Note: Fractures to fingers, toes, face or skull aren’t included in this measure.

Our Medicare Quality team will be working alongside you to close OMW care gaps by contacting members who still need to complete a BMD test to offer them education, guidance and support. For questions on HEDIS measure requirements, visit our 2024 HEDIS Provider Reference Guide.