A major milestone in sleep disorder medical treatment may soon be reached. Medicare has traditionally denied reimbursement for at-home unattended sleep monitoring. However, spurred by greater public and healthcare professional awareness of the dangers of sleep disorders like Obstructive Sleep Apnea, Medicare coverage is poised to change. The Centers for Medicare and Medicaid Services (CMS) will announce its decision on December 14, but it seems likely that more people will be able to identify sleep problems in the comfort of their own bedroom for less cost than overnight in a hospital or sleep lab.
The issue is important enough to be covered by Frost & Sullivan, a leading healthcare consulting firm, in a recent research article. Published in Vital Signs–Strategic Insights for Healthcare Executives, the article focuses on the growth in sleep disorder treatment, the prospective Medicare decision, and the resulting potential 30% revenue increase for sleep service providers. The article notes, “At a recent CMS meeting on September 12, 2007 the MedCAC (Medicare Evidence Development & Coverage Advisory Committee) members appeared to vote in favor of approving in-home unattended portable home testing for CMS beneficiaries.” Subject to a positive December 14th decision, Medicare coverage will be extended nationwide for unattended home sleep monitoring.
SleepQuest, Inc. has long been a leader in providing at-home sleep services and was extensively profiled in the Frost & Sullivan article. “For over 10 years,” according to Robert Koenigsberg, company President, “our firm has been one of the few organizations to successfully implement unattended home sleep monitoring, as prescribed by physicians and for the benefit of patients needing an affordable pathway to diagnosis and treatment of obstructive sleep apnea. Our proven approach to in-home sleep medicine and disease control management, which meets all CMS requirements, saves patients time, money and the discomfort of unfamiliar overnight confinement.” SleepQuest’s Chief Scientific Officer, Dr. William C. Dement, a pioneering sleep researcher, presented on behalf of the Company in favor of approving coverage at the MedCAC meeting in September.
Koenigsberg adds, “Two major insurance providers in certain US regions have helped bring about this progressive Medicare support step. Both CIGNA and Blue Cross should be congratulated for their humanitarian leadership. Over 10% of the US population suffers from sleep related breathing disorders that should be identified and treated. The two most prevalent of these are obstructive sleep apnea syndrome and upper airway resistance syndrome.”
The Medicare decision will improve diagnostic and treatment options for all patients. “When SleepQuest takes on the role of sleep care provider, patients benefit from our disease management approach toward creating wellness for those suffering from unexplained fatigue and interrupted breathing while sleeping” states Koenigsberg. “This has resulted in an up to 93% treatment compliance rate as compared to the sleep monitoring industry’s less than 50% rate. Our success is a result of our company’s sleep care specialists and dedicated sleep physicians under the leadership of Dr. Dement.”