Sleep Health

Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder in the United States, affecting approximately 25 million Americans. Of these, more than 80% are undiagnosed.[1] Left untreated, OSA places individuals at increased risk for hypertension, stroke, heart disease, diabetes and other comorbidities, accounting for $30 billion in increased health care utilization and medication costs.[2] Currently, more than 70% of sleep tests are conducted in high-cost sleep facilities. Once diagnosed, fewer than half of indiviudals adhere to their prescribed sleep therapy.[3]

Magellan Healthcare’s Sleep Health solution focuses on the approapriate assessment of OSA.

Sleep Health Key Features
  • Care direction to the right test, setting or treatment—Sophisticated clinical intake algorithms inform providers which test type is most appropriate and guide members to lower-cost home sleep tests when clinically indicated
  • Auto-approval at intake—Automatic approval of requests meeting medical necessity criteria reduce administrative burden and provider abrasion
  • Specialty-trained staff—Pulmonologists, otolaryngologists, neurologists and psychiatrists review pended cases to ensure medical necessity and clinical appropriateness
  • Coordination with network sleep labs—Attended sleep studies are conducted by trained sleep technologists when medically necessary to support appropriate care
  • Robust data analytics—Actionable insights on utilization, trends and costs help maximize savings
Interested in learning more?

Contact us to learn how Magellan Healthcare’s comprehensive Sleep Health solution lowers costs and reduces waste by ensuring appropriate diagnostic testing for sleep disorders.


[1] https://aasm.org/rising-prevalence-of-sleep-apnea-in -u-s-threatens-public-health/

[2] https://aasm.org/economic-burden-of-undiagnosed-sleep-apnea-in -u-s-is -nearly-150b-per-year/

[3] https://j2vjt3dnbra3ps7ll1clb4q2-wpengine.netdna-ssl.com/wp-content/uploads/2017/10/sleep-apnea-economic-crisis.pdf