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Dr. Caroline Cicero Headshot

$60 Billion in Preventable Medicare Costs

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Sept. 22 is National Falls Prevention Awareness Day -- a day to highlight steps we all need to take in reducing public costs as well as older adults' fall-related pain, injury, and deaths.

The Centers for Disease Control and Prevention expect that within eight years, Medicare's expenses for beneficiaries' fall-related injuries will cost us $60 billion per year. That means between now and the time we inaugurate a new president after the 2020 election, America will have spent almost half a trillion dollars to treat older adults who fall. However, with targeted community prevention programs, personal assessment and initiative, and attentive physician involvement, falls among older people are preventable.

Despite the destructive, incomprehensible partisan bickering, misleading claims, and generational warfare we have heard recently about Medicare's financing, Republican, Democrat, and Independent Senators have resolved to work towards the constructive, common goal of reducing the human and financial cost of falls. Incidentally, reducing fiscal costs is a major component of the Affordable Care Act, and the independent Congressional Budget Office reported in July that repealing "Obamacare" would add $716 billion in costs back to Medicare between now and 2022. Cutting out preventable falls could save billions more.

As Chair of the Senate Special Committee on Aging, veteran Senator Herbert Kohl (D-WI) -- yes Wisconsin, Representative Paul Ryan's home state -- led the Senate Resolution to declare Sept. 22 an important step in a long-term effort to rein in Medicare costs. Six other senators also sponsored Senate Resolution 553: Sen. Richard Blumenthal (D-CT), Sen. Robert Casey Jr. (D-PA), Sen. Susan Collins (R-ME), Sen. Michael Enzi (R-WY), Sen. Barbara Mikulski (D-MD), and Sen. Bernie Sanders (I-VT).

Fall prevention efforts have the attention of public health leaders in these seven senators' states. In total, 43 states and the District of Columbia have Fall Prevention Coalitions which are working on the state and local levels to educate older adults, policy makers, health departments, doctors, and other service providers on the urgency of preventing falls. These efforts result from the hard work of the National Council on Aging's Falls Free Initiative, the Fall Prevention Center of Excellence, the U.S. Administration on Aging, the Centers for Disease Control and Prevention, and private funders such as the California-based Archstone Foundation.

Whether from tumbling off a ladder while hanging Christmas lights, skidding on an icy sidewalk, tripping over a tree root in the front yard, stumbling over clutter inside the living room, swooning from over-medication, or slipping in the bath tub, more than 20,000 older Americans die each year from falling. Fall-induced head and internal injuries are what typically result in death. More than two million older people who fall are treated in emergency rooms, and 650,000 are hospitalized. For those older adults who are not hospitalized, a fall is often still a cue that something needs attention -- bad mix of medications or over-medication, decreasing vision, poor nutrition, decreased strength and balance, inadequate footwear, or hazardous living environment.

Many who fall and break a hip never walk again and spend the rest of their days living in nursing homes. When falls result in institutionalization and long term care, the fiscal impact reaches far beyond the federal government and Medicare. States pay for falls when lower income older adults end up on long term Medicaid. Private insurance companies, including HMOs that benefit from participation in lucrative Medicare Advantage Plans, realize that they will be able to maximize Medicare subsidies if they educate their patients and health care providers in how to prevent falls. Likewise, government endorsed and sponsored education and prevention efforts aimed at older adults and their health care providers will help reduce falls and their expensive financial impact on taxpayers. Appropriations of $12 million for Fall Prevention Programs in the FY13 Federal Budget will offer returns on Medicare savings over the next decade. Tossing out millions of dollars of prevention programs that can save billions in health care expenditures and Medicare funds would be a reckless fall.