Providers eye home sleep test market

Thursday, July 7, 2011

YARMOUTH, Maine - CPAP providers are working hard to make sure they have a place in the wild west of home sleep testing.

Although most providers don't offer home sleep testing, some seek to align themselves with third-party payers and independent diagnostic testing facilities (IDTFs) that are increasingly using the tool. With the cost of a home sleep test falling somewhere in the hundreds of dollars compared to up to a couple of thousand dollars for a lab study, it's probably no surprise that payers are warming up to home sleep testing. 

But the shift toward home sleep testing means sleep labs could stand to lose a lot of business. So providers have to walk a fine line between establishing new business and maintaining relationships with sleep labs.

"The sleep labs are going to have to understand that these patients are going to be taken care of without them," said Todd Cressler, president of CressCare Medical in Harrisburg, Pa.

Providers in Pennsylvania have seen these changes firsthand. In Pennsylvania, commercial insurer HealthAmerica requires its members who need a sleep study to use home sleep testing. The payer has partnered with NovaSom, a manufacturer and provider of home sleep testing devices and services, to do the tests.

"If you have HealthAmerica and your brother owns a sleep lab, they will not pay," said Terry Luft, president of ESMS Home Medical in Pittsburgh. "The sleep labs are up in arms. They are looking to the DME community saying, 'You're not going to partner with these people.'"

But in fact, that's just what some providers plan to do.

"We are actively pursuing this and meeting with NovaSom," said Cressler. "Their success is going to be based on the ability of the DME who is managing these patients to be able to successfully clinically handle setting them up. We can handle all aspects of that."

Ideally, there is room for everyone to help the patient, says provider Lisa Feierstein. While home sleep tests are gaining widespread acceptance, there is still the matter of ensuring that patients get appropriate therapy.

"In a perfect world, if you are going to do a home sleep test, then you should send them for a titration in the lab and get a good treatment level," said Feierstein, founder of Raleigh, N.C.-based Active Healthcare.

Another group that's enthusiastic about home sleep testing: IDTFs, which are starting to offer the service in addition to oximetry and other testing. Feierstein said she has considered forming a possible partnership with at least one IDTF.

"It's up to the DME to try to partner with the IDTFs," she said. "You just have to figure out where it makes strategic sense."