Sleep benefits manager inks deal with insurer

Friday, July 27, 2012

BOSTON – Sleep Management Solutions (SMS) in May partnered with Neighborhood Health Plan to provide sleep diagnostic and therapy services to the insurer’s 240,000 patients in Massachusetts.

“You’d be hard pressed to find a health plan that isn’t looking at sleep and a program to manage its sleep services,” said Tom Gaffney, president of SMS, a sleep benefits management company owned by CareCentrix. “Studies show that by (treating sleep apnea), the overall use of healthcare services decreases, so there’s a savings for healthcare plans.”

Although SMS coordinates the care, the DME provider is a critical component to the model, said Gaffney.

SMS refers plan members for home sleep tests—about 85% are positive for obstructive sleep apnea or severe sleep apnea. Once the member is diagnosed, a network DME provider sets the patient up on CPAP therapy.

“We rely on our network of providers to support the patient in the marketplace,” said Gaffney.

Members are also enrolled in the iComply Therapy Adherence Program, which supports them during their adjustment to sleep therapy. iComply has two components: Telephone support from respiratory therapists and nurses; and a technology component. Patients are set up on devices that track usage and provide clinical information on issues like leaks and therapeutic pressure.

“That support, with a focus on high touches in early adoption, is really the focus for us to drive a successful compliance program,” said Gaffney. 

Gaffney said he expects the sleep market to continue to grow.

“The medical community is more tuned in to the impact of sleep disordered breathing on other concerns, such as cardiovascular health and hypertension,” he said. “Sleep has finally gained the respect it