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.
- 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
Sleep Health
[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