‘Pieces coming together’ for HST

Friday, August 31, 2012

YARMOUTH, Maine – 2012 could end up being a watershed year for home sleep testing (HST), say vendors that have large stakes in the market.

In the past year, several private payers like Humana and Wellpoint/Anthem have begun requiring preauthorizations for in-lab sleep tests, also know as polysomnography (PSG)—a move that has made home sleep tests more attractive to physicians, vendors say.

“We estimate that, this fall, 65% to 70% of all covered lives under commercial plans will be under preauthorization for PSG,” said Renée Gapen, the diagnostic market manager at ResMed, a manufacturer of medical devices like CPAP machines that are used to treat sleep disorders. “This is the tipping point.”

United Healthcare was one of the first private payers to get the ball rolling when it decided last year, in a nod to the convenience and cost effectiveness of HST, to start performing clinical reviews to determine whether sleep tests could be conducted in the home instead of the lab.

These little pushes from private payers are important because, while home sleep tests are almost always patient-preferred, they’ve been a harder sell to physicians who are more comfortable with the more traditional PSG, vendors say.

“The real impediment has been the doctors learning what HST is and understanding it as an alternative,” said Mark Sorrells, president and CEO of Instant Diagnostic Systems (IDS), which has seen its HST business grow 30% in the past year. “That recognition is starting to happen.”

Vendors would like to get one more group on board with HST: the Federal Motor Carriers Safety Administration. The group has gone back and forth over whether or not to recommend sleep tests for truck drivers and, for those who are diagnosed with disorders, therapy.

“There has been a lot of pushback due to the cost of testing in labs so we’ve been educating them about less expensive home sleep testing,” said Dave Kazynski, president of VGM Homelink, which has contracts with three transportation companies to provide HST. “They used to be completely against it but now they realize they need to do something. There are a lot of pieces that are coming together.”