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  • CDC: Falls-Related Deaths in the US Rose 31% in 10 Years

    Among US residents age 65 and older, the rate of death from falls continues to climb steadily, having increased by 31% between 2007 and 2016, and growing at a particularly rapid rate among those aged 85 and above. The latest statistics, included in a report from the US Centers for Disease Control and Prevention (CDC), point to a need for more widespread falls screening and prevention efforts including physical therapy, authors say.

    During the 10 years tracked in the study, falls-related deaths among US residents 65 and older rose from 18,334 to 29,668—in terms of rates of death from falls, that's an increase from 47 per 100,000 to 61.6 per 100,000 in that age group. Deaths climbed by about 3% per year, according to the report.

    In addition to overall totals and rates, CDC researchers looked at data in terms of demographics and state-by-state variables. Among their findings:

    • In 2016, falls-related deaths per 100,000 were highest among white non-Hispanic US residents (68.7) and the all-ethnicity 85-and-older group (257.9).
    • While death rates increased for all age groups, the 85-and-older category recorded the most dramatic rise between 2007 and 2016, from 9,188 deaths in 2007 to 16,454 in 2016. The 65-to-74 age group recorded 2,594 falls-related deaths in 2007 and 4,479 in 2016; the 75-to-84 age group saw an increase from 6,552 deaths in 2007 to 8,735 in 2016.
    • Men had higher rates of falls-related deaths than did women—73.2 per 100,000 men compared with 54 per 100,000 per women. Researchers believe the gap may be attributable to "differences in the circumstances of a fall," with men tending to experience falls that lead to more serious injuries, such as those sustained in a fall from a ladder or as the result of alcohol consumption.
    • Rates for deaths from falls in the 65-and-older age group varied among states, ranging from 142.7 per 100,000 in Wisconsin to 24.4 per 100,000 in Alabama. Authors aren't sure of the reasons for the variance but suspect that the numbers might be related to demographic variables including differing proportions of older white adults in various states. Another possible explanation cited in the report was the impact of who completes the death certificate: According to the CDC researchers, a 2012 study showed that coroners reported 14% fewer deaths from falls than did medical examiners.

    Authors of the report theorize that the rates of falls-related deaths may be climbing in part because of an aging population and longer survival rates after common diseases including heart disease, cancer, and stroke. Whatever the contributing factors, it's a trend that needs to be addressed, they write: even if the rate were to stabilize, an estimated 43,000 US residents would die from falls in 2030, and if the rate were to climb as it did from 2007 to 2016, some 59,000 individuals may die from falls in 2030.

    "As the US population aged [65 and older] increases, health care providers can address the rising number of deaths from falls in this age group by asking about fall occurrences, assessing gait and balance, reviewing medications, and prescribing interventions such as strength and balance exercises or physical therapy," the report states.

    Better prevention efforts also may result in health care cost savings as well: an earlier report estimated that expenditures on nonfatal falls in the US reached nearly $50 billion in 2015, with medical costs associated with fatal falls coming in at an estimated $754 million.

    APTA provides extensive resources on falls prevention at its Balance and Falls webpage. Offerings include consumer-focused information, online courses, and links to other sources of information, including the CDC and the National Council on Aging. In addition, APTA's PTNow evidence-based practice resource offers a unilateral vestibular hypofunction clinical summary, a summary on falls risk in community-dwelling elders, an osteoporosis clinical summary, and tests and measures such as a fracture risk assessment, a clinical test of sensory interaction and balance, and a self-paced walk test. The association's scientific journal, PTJ (Physical Therapy) has also published a clinical guidance statement from the APTA Academy of Geriatric Physical Therapy on management of falls in community-dwelling older adults.

    CMS Offers Alternative Dispute Resolution for Some Providers With Unresolved Medicare A or B Appeals

    Providers with Medicare Part A or B appeals that have been waiting for a decision are being offered the possibility of resolving those appeals through a new alternative dispute resolution program from the US Centers for Medicare and Medicaid Services (CMS). However, the requirements around just who can qualify for the service, and under what circumstances, are a bit complex—that's why CMS is urging interested providers to review online resources and register now for a May 22 conference call that will attempt to explain the details.

    Called the "Settlement Conference Facilitation" (SCF) program, the initiative is aimed at providers and suppliers who have claims appeals awaiting decisions in the Office of Medicare Hearings and Appeals (OMHA) or Medicare Appeals Council (Council). In the SCF, "a facilitator uses mediation principles to assist the appellant and CMS in working toward a mutually agreeable resolution" to a claims appeal, according to CMS. The facilitator can't make rulings on the merits of a claim, nor can the facilitator serve as a fact-finder; instead, says CMS, the facilitator "may help the appellant and CMS see the relative strengths and weaknesses of their positions."

    To qualify for the program, a provider must have a National Provider Identifier, cannot have or have had False Claims Act litigation pending against them, and cannot have filed for bankruptcy or expect to do so.

    But those are just the provider qualifications. Determining which appeals would qualify for the program is another somewhat more complicated matter, involving the total number of appeals pending, the dollar amounts involved in those appeals, and the codes used in the initial claim, among other requirements.

    To help make things clearer, CMS offers a webpage on the SCF program and urges interested providers to join a conference call on May 22 at 1:30 pm ET. That call requires free advance registration, which closes at noon on May 22 or earlier if spaces fill up. Questions about the SCF can be emailed to OMHA.SCF@hhs.gov.

    This program is separate from the Low-Volume Appeals Initiative CMS announced in February of 2018.