Tag Archives: health

Home Sleep Testing, Sleep Centers

WatchPAT™ Spearheads Breakthrough of At-Home Testing

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New CPT release along with pricing any day between now and 31 October.

• In October 2010, the American Medical Association to announce a new CPT (Current Procedural Terminology) code for at-home testing of obstructive apnea (OSA), which will go into effect January 1, 2011.
• Home testing and diagnosing of OSA will now become uniformly reimbursable for all physicians.
• Home testing with the WatchPAT (wrist-worn device and finger-mounted probe) delivers diagnostic accuracy at a fraction of the cost of testing, significantly lowering the cost of care.
• Several key studies indicate that patients with undiagnosed and untreated OSA utilize care resources almost two-fold higher—with heavier use of resources seen in women.
• Outpatient testing for -related breathing disorders using a wrist-worn device and finger-mounted probe was selected as one of the Top 10 Medical Innovations for 2010 by a panel of experts at the world-renowned Cleveland Clinic.

It is estimated that over 28 million Americans suffer from obstructive apnea (OSA), with approximately 20 million more going undiagnosed and untreated. The -related cost burden for undiagnosed OSA in the United States—a dangerous condition that can lead to a variety of heart ailments, stroke, and death—is estimated at $3.4 billion.

The latest figures compiled by Frost & Sullivan in 2008 show revenues in the U.S. apnea diagnostic and therapeutic market totaling approximately $1.35 billion, with a 16.2% growth rate.

WatchPAT, produced by medical device manufacturer Itamar-Medical, Ltd., is the industry leader for at-home OSA testing. WatchPAT is approved, available for all physicians as a diagnostic tool, and is poised to continue market domination once the CPT (Current Procedural Terminology) code for at-home diagnosis goes into effect January 1, 2011.

“With the new CPT code going into effect, millions of Americans suffering from apnea can now benefit from easy, low cost access to in-home testing using our WatchPAT device,” notes Dr. Dov Rubin, President and CEO of Itamar-Medical. “Patients can now take the test in the comfort of their own bed, affording them timely diagnosis and treatment for apnea, which is linked to other ailments such as heart disease, hypertension, and obesity.”

Rubin also adds, “Internists, cardiologists, and family physicians can now order the tests and get reimbursed. Using Itamar-Medical’s WatchPORTAL technology, physicians can download the information instantaneously at no extra charge and obtain a diagnosis in consultation with a local physician or via Itamar’s nationwide network of experts, with results wirelessly delivered back to a smartphone.”

WatchPAT tests outnumber the nearest competitor by 5:1, making it by far the most used at-home apnea testing device of its kind. While PSG (polysomnography) testing has been the standard of care for OSA diagnosis, it is anticipated that many labs will also be offering home testing in order to expand their services. In a July 2010 Wells Fargo Securities survey of national centers, analysts reported that 21% of centers currently offer home testing for Medicare patients and 23% offer home testing for privately insured patients, both 20% jumps from a previous survey.

Additionally, another 29% of centers plan to offer home tests in the next six months, a 19% increase since their previous survey. Moreover, 38% of the respondents indicated that they plan to increase involvement in home testing, up from 32% from the prior survey.

According to Dr. Steven Lamm, a New York internist who regularly performs WatchPAT tests on his patients, “With WatchPAT and the new CPT code, we now have the technology that will allow community doctors nationwide easy access to diagnosing apnea. Because of that, the role of the will change. testing is still extremely important, though I want to reserve it for those patients with especially complicated issues, such as , insomnia, and narcolepsy.”

Source: Itamar-Medical Ltd

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Home Sleep Testing, Medicare

Sleep Management Solutions Acquired by CareCentrix

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Acquisition Expands Company’s Home Health Care Services to Include Management

HARTFORD, Conn., Jan. 11, 2011 – CareCentrix Inc announced today that it has acquired Sleep Management Solutions LLC (SMS), a company specializing in sleep benefits management.

With the acquisition of SMS, CareCentrix expands its services into the fast-growing area of sleep benefits management.   SMS provides health plans with a comprehensive program focused on improving patient outcomes and reducing the cost of sleep services.  The company provides Home Sleep Testing (HST) technology to qualifying patients who conduct their prescribed sleep diagnostic test in their homes, enabling a more natural for testing at less cost than a facility.  SMS also follows up with people who are approved for sleep therapy devices to ensure they are using the equipment properly and following their prescribed treatment.  HST adoption has increased significantly since the Centers for Medicaid and Medicare Services approved it for treatment in 2008.

“As awareness of sleep disorders has grown, employers and insurers have seen a 15 – 20 percent annual increase in the cost of diagnostic testing and medical equipment to treat these conditions. SMS’s home testing program has saved health plans approximately $.50 per member per month on their benefit spend.  Its integrated approach to sleep benefits management is directly in line with CareCentrix’s vision to bring innovative home-based services to health plans and their members that result in improved quality of care at a reduced overall cost,” said Eric Reimer, chief executive officer, CareCentrix.

“We are excited to join CareCentrix. Our companies share a common vision to bring high-quality services into the home setting where the individual is most comfortable and costs are lower,” said Tom Gaffney, chief operating officer of SMS, who has been appointed senior vice president of sleep management services at CareCentrix.  ”The combination of SMS’s end-to-end sleep management system with CareCentrix’s expertise in home benefits management and cost containment will bring additional savings and benefits to our existing and new customers.”

About CareCentrix

Founded in 1996, CareCentrix manages home nursing, infusion and medical equipment services for more than 20 million people across the country through a network of 5,000 credentialed home care providers. The company provides health care plans and providers with a one-stop solution that coordinates care for patients in the home including skilled nursing services, durable medical equipment and home infusion drug therapies. CareCentrix recently expanded its services with the development of a new program that will help payers and providers reduce the rising rate of hospital readmissions.  CareCentrix is headquartered in East Hartford, Connecticut, and has operations in Melville, New York; Phoenix, Arizona; Tampa, Florida;Albuquerque, New Mexico; and Overland Park, Kansas.  For more information about CareCentrix visit www.carecentrix.com.

About Sleep Management Solutions

Founded in 2006 Sleep Management Solutions, LLC is the first Sleep Benefits Management Company in the country developed to work with the payer community to effectively manage the growing costs associated with sleep services.  The company provides an end-to-end integrated approach to managing the sleep continuum with a keen focus on enhancing both clinical and financial quality for payer clients.  Sleep Management Solutions has offices operations in Suffield, Connecticut, Charleston, West Virginia, East Longmeadow, Massachusetts; and Greensboro, North Carolina.  For more information about Sleep Management Solutions visit www.sleepmanagementsolutions.com

SOURCE CareCentrix, Inc.

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Otalaryngology

New Clinical Practice Guidelines Issued for Tonsillectomy

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The American Academy of Otolaryngology & Head and Neck Surgery (AAO-HNS) has issued new which states most children with frequent throat infections do not need tonsillectomy surgery.

The practice guidelines is published in the January issue of – Head and Neck Surgery.

Click here to read the full article.

http://oto.sagepub.com/content/144/1_suppl/S1.full

The AAO-HNS is the world’s largest organization representing specialists who treat the ear, nose, throat, and related structures of the head and neck. The Academy represents more than 12,000 otolaryngologist—head and neck surgeons (ENTs) who diagnose and treat disorders of those areas.

The guidelines was developed using a systematic literature search which was condensed into evidence-based statements with associated balance of benefit and harm. The guideline panel members were chosen to represent fields of sleep medicine, advanced practice nursing, anesthesiology, infectious disease, family medicine, otolaryngology–head and neck surgery, pediatrics, and consumers.

The panel notes “Guidelines are never intended to supersede professional judgment; rather, they may be viewed as a relative constraint on individual clinician discretion in a particular clinical circumstance.”

The guideline panel recommendations—

1. Watchful waiting for recurrent throat infection: Clinicians should recommend watchful waiting for recurrent throat infection if there have been fewer than 7 episodes in the past year or fewer than 5 episodes per year in the past 2 years or fewer than 3 episodes per year in the past 3 years.

2. Recurrent throat infection with documentation: Clinicians may recommend tonsillectomy for recurrent throat infection with a frequency of at least 7 episodes in the past year or at least 5 episodes per year for 2 years or at least 3 episodes per year for 3 years with documentation in the medical record for each episode of sore throat and one or more of the following: temperature >38.3°C, cervical adenopathy, tonsillar exudate, or positive test for Group A β-hemolytic streptococcus (GABHS).

3. Tonsillectomy for recurrent infection with modifying factors: Clinicians should assess the child with recurrent throat infection who does not meet criteria in Statement 2 for modifying factors that may nonetheless favor tonsillectomy, which may include but are not limited to multiple antibiotic allergy/intolerance, PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and adenitis), or history of peritonsillar abscess.

4. Tonsillectomy for sleep-disordered breathing: Clinicians should ask caregivers of children with sleep-disordered breathing and tonsil hypertrophy about co-morbid conditions that might improve after tonsillectomy, including growth retardation, poor school performance, enuresis, and behavioral problems.

5. Tonsillectomy and polysomnography (sleep study): Clinicians should counsel caregivers about tonsillectomy as a means to improve in children with abnormal polysomnography who also have tonsil hypertrophy and sleep-disordered breathing.

6. Outcome assessment for sleep-disordered breathing: Clinicians should counsel caregivers and explain that SDB may persist or recur after tonsillectomy and may require further management.

7. Intraoperative steriods: Clinicians should administer a single, intraoperative dose of intravenous dexamethasone to children undergoing tonsillectomy.

8. Perioperative antibioticse: Clinicians should not routinely administer or prescribe perioperative antibiotics to children undergoing tonsillectomy.

9. Postoperative pain control: The clinician should advocate for pain management after tonsillectomy and educate caregivers about the importance of managing and reassessing pain.

10. Posttonsillectomy hemorrhage (bleeding): Clinicians who perform tonsillectomy should determine their rate of primary and secondary posttonsillectomy hemorrhage at least annually.

Source reference: ”Clinical Practice Guideline: Tonsillectomy in Children” Otolaryngoly Head Neck Surg 2011

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