Among those 65 and older, the Centers for Disease Control reports falls are the leading cause of injury deaths and responsible for nearly 3 million emergency department visits each year. The Stopping Addiction and Falls for the Elderly (SAFE) Act was introduced in March to study and reduce the impact of this combined public health threat.

If passed, the SAFE Act would allow Medicare beneficiaries to undergo fall risk assessments performed by occupational and physical therapists through their existing yearly Medicare wellness benefits.

Staffing for fall risk assessments could change

If enacted, this legislation could have several possible effects. Firstly, the SAFE Act would likely expedite the process of completing these evaluations. Most health plans currently contract with independent or agency-affiliated registered nurses as well as primary care physicians to perform fall risk assessments. However, the national nursing and physician shortages have led many payers to experience a backlog in this area.

By having rehabilitation professionals perform fall risk evaluations, health plans can maintain their focus on preventive care and fulfill benefit offerings more efficiently. In addition, payers can trim their budget for these assessments by eliminating the need to pay higher premiums to recruit these in-demand professionals.

The most recent data on non-fatal falls shows that Medicare spends a whopping $28.9 billion per year in this area, along with another $754 million yearly for fatal falls. With falls and their associated injuries and management being a large cost to all health plans, payers that offer Medicare plans would likely see some savings if the SAFE Act was finalized.

Ripple effect may influence opioid prescription and usage

Many people may assume otherwise, but older adults are also disproportionately affected by the opioid crisis. In fact, Medicare data indicates a 300% increase in opioid use disorder in older adults since 2013. Older adults also have a higher rate than the general population of experiencing chronic pain. In turn, it’s not uncommon for opioids to be prescribed to this population to help manage pain management after serious falls.

Reducing the frequency and risk of falls by any amount can help lower the amount of opioids prescribed to older adults. It should also be recognized that older adults are more at risk of experiencing the adverse effects of opiates due to altered pharmacodynamics. This includes falls leading to hip and spinal fractures.

Counseling older patients on how to reduce their fall risk while also steering health care providers to prioritize pain management solutions that don’t involve opiates enhances both member wellness and the bottom line.

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