Senate Aging Committee Seeks Community Input on Falls Prevention

Click HERE to read Senators Collins and Casey’s letter

Washington, D.C.—U.S. Senators Susan Collins (R-ME) and Bob Casey (D-PA), the Chairman and Ranking Member of the Senate Aging Committee, are requesting stakeholders to provide recommendations to reduce older Americans’ risk of falls and fall-related injuries.  The feedback will be compiled for a report the Committee is authoring to bring attention to this common and dangerous event. 

Comments can be sent to the Aging Committee via email at AnnualReport@aging.senate.gov. The deadline to respond is June 26, 2019.  All submitted comments will be considered part of the official public record. 

In 2016, approximately three million older adults were treated in emergency rooms after falling.  Even if an older adult avoids a major injury, a fall can still have a cascading effect on health. After falling once, an older adult may restrict his or her activity out of fear of falling again. This can lead to a decline in physical health as well as social isolation and depression. 

The annual total direct medical cost of fall-related injuries for older adults is approximately $50 billion.  The average hospital cost for a fall injury is more than $30,000.  May is National Osteoporosis Month. A fracture sustained during a fall is often the first sign of advanced osteoporosis.

The Aging Committee is specifically soliciting input on the following questions:

• Reporting and Follow-Up. To what extent are falls unreported among older Americans? What strategies can be employed to encourage patients to promptly notify their health care provider or caregivers of a fall? How can follow-up with appropriate healthcare providers be improved after a visit to an emergency department for a fall?

• Tools and Resources. What learning tools, resources or techniques can be used to empower patients to change their home environment or modify risk factors to reduce the risk of falls? What are the opportunities and limitations surrounding assistive technologies? Are there are any federal policy barriers that make it difficult to offer tools and resources to patients to prevent falls?

• Medicare. How can the “Welcome to Medicare” visit or the “Annual Wellness” visits be improved to better assess fall risk and fracture prevention and ensure appropriate referrals? How can Medicare coverage and reimbursement for falls prevention and fall-related services be improved? How are existing Medicaid waivers being utilized for falls prevention and fall-related services? Are there demonstrations or pilot programs that the Center for Medicare and Medicaid Innovation should consider?

• Evidence-Based Practices. Are there evidence-based practices that reduce the rate of additional bone fractures among those older Americans who have fallen and broken or fractured bones? Are there regional differences in the utilization of these services, evaluations, or screenings? Are there models (such as the Million Hearts Campaign) for other health conditions that have applicability to reducing the overall rate and impact of falls among the elderly?

• Polypharmacy. What recommendations do you have to ensure prescribers take into account the relationship between polypharmacy and falls risk when making both initial and follow-up clinical decisions for high-risk patients? Is there a need for increased research on the link between polypharmacy and falls-related deaths and/or injuries?

• Transitions of Care. How can the transitional period from a hospital or skilled nursing facility to the home be improved in assessing the home for fall risks? What more could be done by government agencies to support fall risk assessments and the implementation of protocols that could be used to prevent falls in the home care population?

• Post-Fracture Care. What can be done to create a care pathway for patients post-fracture to ensure proper follow up care and prevention of future fractures? Are there best practice models that can provide implementation opportunities? Are there any federal policy barriers to implementing best practices in post-fracture care?