Complete Sleep Apnea Care and Diabetes A Study on Total Cost Savings

Transcription

1 A Study on Total Cost Savings

2 Our Leadership In Sleep Apnea Care Nevada Sleep Diagnostics, Inc. has a fifteen year history of leadership in sleep apnea care. Nevada Sleep Diagnostics consistently raises standards of care, including quality and patient safety, as evidenced by our Joint Commission certification since Community Education and Engagement and Physician Education in Sleep Apnea produces a community with a strong awareness of this serious medical condition.

3 Our Leadership in Sleep Apnea Care Advanced Technology has been central to our promotion of the consequences of sleep apnea; the diagnosis and treatment of our continuously growing patient base; and the important priority of keeping costs low while, at the same time, offering high quality. A foundation of technology, skilled technologists, health care professionals and supplier support offers responsive resources.

4 Diabetes: A CASE STUDY

5 Diabetes: A Serious Medical Condition Diabetes is a common, chronic and progressive disease. Shortens life expectancy by as much as 15 years. Both CAUSE and CONSEQUENCE to cardiovascular disease. Diabetic Population is at heightened risk of heart attack, stroke, amputation, blindness and kidney failure.

6 Diabetes Challenges: Prevalence Diabetes is a devastating global public health threat that currently affects 366 million people worldwide according to the International Diabetes Federation (IDF). In 2011, the prevalence rate of Diabetes in the United States was 8.3%, with 25.8 million people suffering from Diabetes. The prevalence of Diabetes in Nevada increased from 4.2% in 1996 to 8.5% in 2010.

7 Diabetes Challenges: Cost The United States national economic burden of prediabetes and diabetes has reached $218 billion. United Healthcare estimates that the annual cost of a diabetic patient is $22,000. Total cost for Diabetes related hospitalizations in Nevada was $161,460,917 in Average cost per diabetic hospital discharge in Nevada is $37,689.

8 Diabetes & Sleep Apnea Sleep Apnea and Type 2 Diabetes are common disorders that often coexist. Almost 50% of Type 2 Diabetes patients have sleep apnea. Some studies suggest the prevalence of Diabetic patients with sleep apnea is as high as 70%. Sleep Apnea exacerbates Diabetes by increasing glucose intolerance and insulin resistance. Patients with Type 2 Diabetes who are also obese have an 86% prevalence of sleep apnea.

9 Effects of Sleep Apnea Treatment on Type 2 Diabetes Studies have shown that when apneic events are prevented by the use of a CPAP, patients experience lower and more stable glucose levels. Insulin responsiveness increases 28% in patients with Type 2 Diabetes after 4 months of CPAP therapy. CPAP therapy significantly improves insulin sensitivity in 40% of patients with Sleep Apnea. This improvement was observed within 2 days of treatment and sustained over 3 months.

10 Effects of Sleep Apnea Treatment on Type 2 Diabetes: Insulin Sensitivity Improvement of ISI (Insulin Sensitivity Index) at baseline, after two days and three months after onset of CPAP treatment in 31 patients. Harsch et al. Am J Respir Crit Care Med, 2004

11 Benefit: Reduction in Healthcare Costs An Effective Sleep Apnea Care Program Minimizes the affects and reduces the risk of developing Type 2 Diabetes. Reduces the burden of healthcare costs over time.

12 A Perspective on Total Cost Savings Union Pacific Railroad Employees Health Systems (UPREHS) Study

13 Union Pacific Railroad Employees Health Systems (UPREHS) Study OBJECTIVE: To determine if medical expenses were reduced after implementation of a Sleep Disordered Breathing (SDB) education program. Educated their membership of 22,275 on SDB, tested likely candidates, and offered treatment monitored by a registered sleep technologist (with prescribing physician) to the necessary members. Medical costs of all members non-sdb group, the SDB not on therapy group (SDB-NT) and the SDB on PAP therapy (SDB-PAP) groups over four years analyzed. Study represents full membership population, not only diabetic membership.

14 UPREHS: Overall Medical Costs Per Member Per month (PMPM) Non-SDB group SDB-NT (no therapy) SDB-PAP (therapy) (Potts, et al. Pop Health Mgmt, 2012) In the first year of the campaign, overall medical costs were higher for the SDB-PAP group. This is attributable to the cost of diagnosis, PAP device and supplies. The benefit of treatment is seen in the second year, when medical costs for the SDB-PAP group dip below the medical costs of the SDB-NT group by $48 per member per month, and as much as $200 per member per month in the fourth year.

15 UPREHS Study: In-patient Hospital Costs Per Member Per Month (PMPM) SDB-NT group SDB-PAP group Non SDB group Inpatient hospital costs were the lowest for the non-sdb group. Prior to campaign, costs for SDB-PAP and SDB-NT were similar. After campaign, the inpatient costs were lower each year for the SDB-PAP group than the SDB-NT group, by as much as $142 in the fourth year. (Potts, et al. Pop Health Mgmt, 2012)

16 UPREHS STUDY: Number of Hospital Admissions per 1000 Members Throughout the study, hospital admissions were lowest for the non-sdb group. At onset, SDB-PAP and SDB-NT groups were the same. After the campaign, the number of admissions each year was lower for the SDB-PAP Group than the SDB-NT group. NON-SDB Group SDB-PAP Group SDB-NT Group (Potts, et al. Pop Health Mgmt, 2012)

17 UPREHS STUDY: Outcome OUTCOME: The cost of a SDB education program along with the treatment of SDB patients was significantly less than the cost benefit demonstrated after the first year. The UPREHS study found that a low-cost, patient-focused SDB education program can improve health care outcomes and reduce medical expenses. In the 2 years after the education campaign was initiated, the health care plan realized a differential saving of $4.9 million for members with SDB who were treated with PAP therapy compared to those who were not treated. The overall medical PMPM costs were reduced 11.1% in the 12 months after starting PAP therapy, with a $200 PMPM return on investment for those members enrolled in the program. The study concluded that health care plans could realize considerable cost savings if their members with SDB were treated with PAP therapy.

18 How we can help?

19 Community Education and Engagement Website Brochures Primary Care Physician Education

20 Program Screening & Testing Options Screening Questionnaire Advanced Screening and Testing Devices Portable Diagnostic Testing In-lab Diagnostic Testing, when necessary Automatic & Flexible Treatment Devices Continuous Sleep Apnea Assessment, Adherence, and Compliance

21 Optimize Health Benefits and Outcomes (including costs) by diagnosing and treating patients with serious symptoms and chronic conditions (such as diabetes) first.

22 Nevada Sleep Diagnostics, Inc. works diligently to provide the best patient care and quality at favorable price.

23 We are Number 1 in Experience, Credentials, Longevity and Market Trust Over 40,000 Sleep Studies Performed 1,000 Nevada Physicians Trust us with their Patients Family Owned & Independently Operated Medicare Certified, Board of Pharmacy Licensed Joint Commission Accredited Since 2001 Joint Commission Infection Control Standards 4 Board Certified Sleep Physicians Pulmonary, Neurology, and Critical Care Sleep Specialists 14 Credentialed Technologists 18 Patient Care Specialists CPAP Equipment and Supplies 24/7 Coverage Server and Web-based Technology and Applications Comprehensive Sleep Apnea Management including the latest Technology in Screening, Diagnostics, Treatment and Follow-up

24 Accreditation Means Commitment to Patient Care Ambulatory Care Home Care