Podcast Summary: Closing the Gap — The Case for Post-Fracture Care

Podcast: Becker’s Healthcare Podcast
Episode Title: Closing the Gap: The Case for Post-Fracture Care
Date: December 16, 2025
Guests:

• Jared Torkelson, Physician Assistant, Orthopedic Surgery and Sports Medicine, Mayo Clinic Health System
• Matt Bruns, Certified Orthopedic Nurse Practitioner & Clinical Densitometrist, SSM Health Orthopedics
  Host: Kristin Buessman, Marketing Director, Health Systems & Key Accounts, Amgen

Episode Overview

This episode delves into post-fracture care (PFC) and why health systems should prioritize dedicated programs for patients who have suffered osteoporotic fractures. Drawing on their frontline experience, Jared Torkelson and Matt Bruns discuss the challenges, solutions, and system-wide benefits of post-fracture care management—highlighting its role in improving outcomes, reducing costs, and supporting health system efficiency.

Key Discussion Points & Insights

1. Understanding the Challenge of Osteoporosis and Fracture Gaps

• High Prevalence and Treatment Gaps

  • Osteoporotic fractures are frequent, particularly among women over 55.
  • Quote:

    "Every 20 seconds in the US a woman over age 55 will suffer an osteoporotic related fracture. And the majority of these women over the age of 50 do not receive formal osteoporosis care."
    — Matt Bruns (01:28)

  • Many patients do not receive adequate osteoporosis management post-fracture, leading to high rates of subsequent fractures.

• Financial and Systemic Burden

  • Projected osteoporosis-related fracture care costs may exceed $95 million by 2040.
  • The lack of post-fracture care leads to repeated hospitalizations and resource drain.
  • Quote:

    "By 2040, it's projected that osteoporosis related fracture care is going to cost over 95 million."
    — Jared Torkelson (02:12)

2. Establishing and Running Post-Fracture Care Programs

• Mayo Clinic Health System Approach (Jared Torkelson)

  • Integrated bone health and FLS (Fracture Liaison Service) clinic for over eight years.
  • Use of telehealth expanded access, crucial for rural populations.
  • Emphasized creating dedicated protocols for efficiency (e.g., tests, prior authorizations).
  • Tracked patient metrics: 500 new patients last year, mostly hip and wrist fractures.
  • Early intervention targets refracture risk — aim for follow-up within six weeks post-fracture.
  • Notable Quote:

    "It's tough because with osteoporosis in the past, no one's really owned it... So trying to take that time with the patient and bring all those things together so... We're not missing something along the way."
    — Jared Torkelson (03:27)

  • Cost avoidance: 15 hip fractures prevented = 60 hospital bed stays saved.

• SSM Health Orthopedics Approach (Matt Bruns)

  • Post-fracture care begins at the Emergency Room for hip fractures, emphasizing rapid ER-to-OR transition (within 24 hours).
  • Focus on streamlined care plans to reduce delirium, confusion, and hospital length of stay.
  • Employs care managers and nurse navigators for patient/family education on osteoporosis.
  • Combines inpatient and outpatient care, providing take-home materials for long-term osteoporosis management.
  • Notable Quote:

    "Our post fracture care program starts as soon as the patient hits the emergency room door with that hip fracture..."
    — Matt Bruns (05:27)

3. Streamlining Workflows, Processes, and Measurement

• Patient & System Benefits Intertwined

  • Preventing refractures (up to 30% with a well-run FLS) saves costs, resources, and improves patient outcomes.
  • Quote:

    "A good, well running FLS service or bone health clinic can prevent roughly 30% of your refractures..."
    — Jared Torkelson (07:26)

  • Avoids expensive revision surgeries, lessens caregiver burden.

• Tracking Outcomes

  • SSM is developing a dashboard for real-time metrics from both inpatient and outpatient settings.
  • Emphasis on closing care gaps and tracking follow-ups via EMR-driven order sets.
  • Quote:

    "We certainly see the fruit of that [workflow optimization]... Hopefully in the real near future we'll be able to put a number to our successes..."
    — Matt Bruns (08:37)

4. Aligning Post-Fracture Care with Health System Goals

• Value-Based Care & Chronic Disease Management
  • PFC programs align with health systems’ shift toward value-based care, emphasizing quality outcomes and cost management.
  • Integration with broader initiatives for chronic/complex patients enables a holistic care approach.
  • Quote:

    "PFC programs naturally complement health systems emphasis on the value based care that we need to provide."
    — Jared Torkelson (09:44)

• Continuous Measurement and Improvement
  • Importance of robust frameworks for tracking success and using telemedicine for ongoing care.
  • Prioritize staff education and professional development to maintain momentum.

5. Implementation Advice for Health System Leaders

• Start Small, Scale Up

  • Tackle the osteoporosis care gap incrementally—focus first on certain fracture types (hip/wrist).
  • Develop and optimize care pathways before expanding to broader populations.
  • Quote:

    "With any big project, right, you got to start small... So start with hip fractures or wrist fractures... Figure out your pathways, figure out what works, what doesn't..."
    — Jared Torkelson (11:38)

  • Measure what matters: patient satisfaction, reduction in fractures, cost savings.

• Find Physician Champions and Use Existing Models

  • Identify leaders who can drive the initiative.
  • Leverage proven models (“don’t reinvent the wheel”) for scalable, system-wide program design.
  • Quote:

    "Finding a physician champion or the leader that's going to take this forward is extremely important... Don't start from scratch. There are lots of models that have been well documented..."
    — Matt Bruns (12:47)

Notable Quotes & Memorable Moments

• "Every 20 seconds in the US a woman over age 55 will suffer an osteoporotic related fracture. And the majority...do not receive formal osteoporosis care."
  — Matt Bruns (01:28)

• "We don't like talking about money, but if you can take those beds, one, the patient's in a better position because they never had that fracture, but two, you're saving that for your elective procedures that are going to be more valuable to the hospital system overall."
  — Jared Torkelson (04:45)

• "Our post fracture care program starts as soon as the patient hits the emergency room door with that hip fracture."
  — Matt Bruns (05:27)

• "With osteoporosis in the past, no one's really owned it... It's been a primary care issue, it's been orthopedic issue, it's been an endocrinology issue."
  — Jared Torkelson (03:27)

• "You're not going to solve it [the osteoporosis care gap] in a day or even within a year... build your faucets beginning and slowly turn them on over time."
  — Jared Torkelson (11:38)

• "You don't have to reinvent the wheel... we designed our program initially with the entire health system in mind, knowing that we may not have all the resources in place... but it was designed so that it could be scalable."
  — Matt Bruns (12:47)

Key Timestamps

• 01:28 – Matt Bruns: Fracture statistics and care gaps
• 02:12 – Jared Torkelson: Financial burden of osteoporotic fractures
• 02:52–05:16 – Jared Torkelson: Mayo's clinic model & rural/telehealth strategies
• 05:27–07:06 – Matt Bruns: SSM’s ER-based approach, workflow, and education
• 07:26–08:30 – Jared Torkelson: System/patient intertwined benefits; revision cost savings
• 08:37–09:17 – Matt Bruns: Metrics tracking and EMR integration
• 09:44–11:16 – Both guests: Value-based care, program alignment, staff education
• 11:38–12:46 – Jared Torkelson: Implementation advice ("start small," measure everything)
• 12:47–13:53 – Matt Bruns: Finding champions, scalable program design

Conclusion

Both guests highlight the urgent need and outstanding benefits of effective post-fracture care models. From reducing costly hospitalizations and refractures to elevating patient care and system efficiency, the right programs—started small, built around proven models, and driven by interdepartmental champions—can dramatically improve outcomes for patients and health systems alike.

For more episodes and in-depth perspectives, visit beckerspodcast.com.