Older adults who had a fragility fracture are at higher risk to have another fragility fracture, especially if they have osteoporosis. Although there is efficacious treatment to prevent future fragility fracture, less than 20% of patients receive fracture prevention intervention. The Ontario government started a multi-faceted Osteoporosis Strategy that included a Screening Coordinator Program to identify, educate and refer fragility fracture patients in medium and high volume hospital fracture clinics. This program increases rates of osteoporosis testing and treatment but the value for money is unknown. Working closely with those involved in implementing and evaluating the Osteoporosis Strategy, we develop a decision analytic model to assess the cost-effectiveness of a Osteoporosis Screening Coordinator program, when compared with usual care, as delivered in Ontario, Canada.