An Overnight Success

The number of people diagnosed with obstructive sleep apnea continues to rise, making this a lucrative, yet challenging, opportunity for the home medical equipment industry. Patients with OSA, however, are not most providers' classic customers. Namely, they are not typically Medicare beneficiaries, which means providers must rethink how they market to this population. Likewise, payer sources expect positive outcomes, which means patient compliance is integral to the success of an OSA program.

There are certain characteristics that describe the typical OSA patient, such as middle-aged, male and overweight, but research is demonstrating that additional factors also come into play. “Generally, the most affected population is middle-aged males, though postmenopausal women face similar increased incidence,” says Nicholas J. Macmillan, global sleep products manager for Sunrise Medical's Devilbiss division and principal of Outside the Box Consulting.

Ron Richard, ResMed's vice president of marketing for the Americas, adds that about 80 percent of OSA patients are younger than 65, making them ineligible for Medicare benefits.

Some sources say the number of the undiagnosed is extraordinarily high. The National Institutes of Health estimates that 10 million Americans have OSA but are not being treated. “There are still a vast number of individuals who are undiagnosed, particularly because of the lack of institutional beds for sleep studies,” says Bob Mogue, executive vice president of sales and marketing, CareFore Medical.

Home Diagnostics

Mogue's comment raises questions that are currently under debate in the industry. Are in-home sleep studies growing, and are they as effective as those performed in laboratory settings? The commercial side is supportive, say experts.

“There has been more interest in doing in-home diagnostics for sleep from a number of different fronts, specifically, private-pay insurance groups that are looking at this as an alternative or option to in-lab studies due to cost, convenience and access,” says Richard. “On the CMS (Centers for Medicare and Medicaid Services) side or the Medicare side, it looks like it's going in the opposite direction, and they are actually trying to drive patients more to in-lab facilities that are accredited by the American Academy of Sleep Medicine.”