CONSHOHOCKEN, PA — A former U.S. secretary of veterans affairs is calling for a nationwide expansion of hip injury prevention within the Veterans Health Administration, estimating that wearable protection and other interventions could prevent up to 12,100 fractures annually and avoid $826 million in medical costs.
The projections appear in a white paper released by ActiveProtective and authored by David J. Shulkin, the ninth secretary of veterans affairs, and Rebecca J. Tarbert, a physical therapist specializing in geriatric care.
The paper identifies an estimated 400,000 veterans who have both a diagnosed bone-loss condition and a documented history of falls, placing them at elevated risk of hip fractures.
Without additional intervention, that population could experience approximately 13,400 hip fractures annually, according to the paper’s illustrative cost-avoidance model.
Applying a 91% relative risk reduction associated with active wearable airbag systems in peer-reviewed clinical research, the authors estimate that as many as 12,100 fractures could be prevented each year.
The resulting $826 million in projected gross medical cost avoidance implies a break-even cost of less than $14,000 per protected veteran, the paper estimates.
The Veterans Health Administration currently incurs approximately $43 million annually in excess hip fracture costs, according to the authors. That figure excludes rehabilitation, long-term care and caregiver support.
Among male veterans, mortality within one year of a hip fracture can reach 32%. Approximately half of survivors never regain the ability to walk independently, and one in four requires placement in long-term care.
“A hip fracture too often marks the point where that independence is lost,” Shulkin stated. “That’s why I believe preventing these injuries deserves to be a national priority—not simply because it saves healthcare dollars, but because it helps Veterans continue living the lives they earned through their service.”
The proposal distinguishes between preventing falls and reducing injuries when falls occur. It examines three approaches already used or under evaluation within the Department of Veterans Affairs: active wearable airbag systems, passive protective wearables and compliant flooring.
Rather than establishing a separate program, the authors recommend incorporating those measures into existing falls-prevention infrastructure.
“Veterans at highest risk are not hard to find,” Tarbert stated. “They are already in VA’s own systems, flagged by the risk tools clinicians use every day.”
The paper recommends a five-year phased rollout across all 18 Veterans Integrated Service Networks, beginning with facilities that already have established falls-prevention programs.
Other recommendations include identifying high-risk veterans through existing clinical tools, coordinating with the National Falls Prevention Committee and the SAFE STEPS for Veterans Act of 2025, establishing outcome measurements and incorporating independent evaluation from the outset.
ActiveProtective will host a free webinar featuring Shulkin on September 23, 2026, at noon Eastern time. The discussion will address the clinical and economic projections, methods for identifying high-risk veterans and potential next steps for health system leaders, clinicians and veterans service organizations.
The webinar is open to Veterans Health Administration employees, clinicians, veterans service organizations and other interested participants. Registration is available at https://tinyurl.com/37mjt7um.
The white paper can be downloaded at https://tinyurl.com/5anbnf82.
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