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Hanger Institute and CareJourney Publish Novel Study Revealing Racial and Gender Disparities Related to Lower Limb Amputations for Patients with Diabetes


AUSTIN, Texas, and ARLINGTON, Virginia, Sept. 7, 2022 – Hanger, Inc. today announced the findings of a groundbreaking study conducted by the Hanger Institute for Clinical Research and Education in partnership with CareJourney, a leading source of provider cost and quality data. The study examines the timing of lower limb amputation between racial groups and gender for Medicare fee-for-service (FFS) beneficiaries following diabetic foot ulcers (DFU).

Published in the American Diabetes Association’s peer-reviewed journal, Diabetes Care, the study analyzed all Medicare FFS patients with DFU over a five-year period (2012 to 2017), a population of more than 640,000 patients. The results found that Black patients have 98% increased odds of receiving a lower limb amputation within the first year following a DFU diagnosis compared to white beneficiaries. In addition to racial disparities, the study also found moderate differences in care across gender for Medicare FFS patients with DFU, with females having 7-8% increased odds of lower limb amputation occurring later as compared to their male counterparts.

"We've all observed the glaring disparities in quality outcomes by race throughout the pandemic, but these findings were an even greater shock for me,” said Aneesh Chopra, CareJourney President and former U.S. Chief Technology Officer under President Obama. “With one out of three Medicare beneficiaries managing diabetes, it’s imperative that equitable care, driven by clinical evidence, is provided despite race, gender, or any other trait that makes an individual unique. We are grateful for our partnership with the Hanger Institute as it helped us identify these inequities that were otherwise hidden in publicly accessible CMS data."

Diabetes affects more than 37 million people in the U.S., with 25% of those individuals likely to experience a DFU in their lifetime. With longtime data indicating that amputation among this population is significantly more prevalent for people of color, the collaborative study between the Hanger Institute and CareJourney is a result of Hanger’s dedicated clinical research to this focus area, which is a key tenet in its Diversity & Inclusion pledge.

“The first step to dismantling inequities is identifying where they are occurring,” said James Campbell, PhD, Hanger Chief Clinical Officer. “This foundational work provides a springboard to address disparities and our continued efforts to understand the positive and negative impact of earlier or delayed amputation on long-term outcomes, promoting better guidance for evidence-based decision-making.”

More information on the Hanger Institute and CareJourney study can be found on the Hanger Institute’s website:

About Hanger, Inc. – Headquartered in Austin, Texas, Hanger, Inc. (NYSE: HNGR) provides comprehensive, outcomes-based orthotic and prosthetic (O&P) services through its Patient Care segment, with approximately 875 Hanger Clinic locations nationwide. Through its Products & Services segment, Hanger distributes branded and private label O&P devices, products and components, and provides rehabilitative solutions. Recognized by Forbes as one of America’s Best Employers for 2022, and rooted in 160 years of clinical excellence and innovation, Hanger is a purpose-driven company with a vision to lead the O&P markets by providing superior patient care, outcomes, services and value, aimed at empowering human potential. For more information on Hanger, visit

About CareJourney – CareJourney is the healthcare industry’s best source of clinically-relevant analytics for market provider, and patient intelligence. CareJourney’s cloud-based analytics platform helps value-based care organizations build and grow networks, improve provider performance, identify leakage and strengthen referrals, and better manage at-risk populations. CareJourney’s Data-as-a-Service offering enables ACOs, health systems, payers, and HCIT vendors to supercharge their solutions and internal data lakes with high-value insights out of expansive population claims data.

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Media Contacts

Hanger, Inc.

Krisita Burket, Hanger, Inc.


Meghan Williams, Hanger, Inc.



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