Integrating a Virtual Sleep Management program saves ACOs millions

Sleep is considered the third pillar of good health, along with regular exercise and a healthy diet. Unfortunately, in the US, sleep deprivation is reaching epidemic proportions. According to the Centers for Disease Control and Prevention, insufficient sleep is now considered a public health epidemic. Insufficient sleep can arise from lack of opportunity or from prevalent sleep disorders such as obstructive sleep apnea (OSA) and insomnia. Left untreated, these conditions can have serious health consequences, including an increased risk of heart disease, diabetes, and cancer. Most concerning are the challenges patients face when trying to receive treatment due to the broken sleep health system. In the case of OSA, inefficient and costly silos of care have left the majority of patients undiagnosed or untreated, taking an economic toll on our broader healthcare system. 

The prevalence of sleep disorders like OSA and insomnia is substantial and carries significant healthcare costs and productivity costs. OSA affects approximately 18% of the adult US population, with an associated healthcare cost of up to $162 billion. In comparison, chronic insomnia affects about 20% of the adult US population, with health care costs of up to $84 billion. Sleep apnea is associated with several important co-morbidities. Studies have reported increases in all-cause mortality, heart disease, hypertension, and stroke in subsets of OSA patients. According to Dr. Dominic Munafo, Chief Medical Officer for BetterNight, “It’s clear that untreated moderate and severe obstructive sleep apnea certainly has a detrimental impact on our health.” Earlier this year, noted sleep psychologist Dr. Emerson Wickwire reported data on over 287,000 CMS patients. It was the largest analysis of its kind to date. Dr. Wickwire found that untreated sleep apnea was associated with increased overall healthcare utilization, including a rise in hospital visits, ER visits, outpatient visits, and prescription refills per month.

It’s clear that the key to controlling these OSA healthcare costs is to accurately and cost-effectively diagnose and treat the illness. CPAP, the gold standard in sleep apnea treatment, was vital in reducing hospital readmissions in a University of Pennsylvania study. It was reported that 30 days after discharge, partial and non-users of CPAP had much higher rates of cardiovascular disease hospital readmission than those fully compliant with therapy. We know that CPAP usage improves patients’ outcomes and reduces broader healthcare costs. Yet, according to Sleep Review Magazine, about 80% of sleep apnea patients go undiagnosed, and after diagnosis, 50% never receive treatment. For those who have started treatment, there is a low 33% long-term therapeutic adherence rate. This critical gap in effective diagnosis and treatment reflects the broken sleep health system. It is fragmented, costly, and time-consuming. BetterNight has developed a telehealth solution that makes screening, diagnosing, and treating sleep apnea and other sleep conditions, both efficient and affordable. By integrating BetterNight into your ACO, you have the opportunity to achieve outstanding patient outcomes and save money.

BetterNight shows how sleep care management can be straightforward, transparent, and accessible while also providing significant cost efficiencies. The program begins with an online sleep assessment. It then connects the patient to an online board-certified doctor for a telehealth consult. The doctor can then order a home sleep study, and if the resulting diagnosis is sleep apnea, the patient will be set up on CPAP and paired with a sleep coach. For those patients with co-morbid insomnia, there is also a separate module for insomnia, which uses Cognitive Behavioral Therapy as the preferred treatment rather than prescription medications. BetterNight was designed as a modular and adaptable platform that is both compatible and complementary to many practice patterns. This allows patients to enter the platform at a point that best fits their needs. The BetterNight platform provides the convenience and flexibility of a virtual model. Treatment can be completed in as little as two weeks at an average cost of $1300. Perhaps most importantly, BetterNight was built to be a collaborative tool allowing communication to run through all caregivers on the care path. BetterNight can help practices expand their reach, reduce overhead, and increase revenue. BetterNight has a 99% patient satisfaction rate, a 50% increased conversion rate from diagnosis to treatment, and a 67% adherence rate after one year—twice the national average.

Sharp Community Medical Group has been in partnership with BetterNight for 22 years. Chief Medical Officer, Dr. Lynne Milgram, realized her medical group’s efforts to treat sleep apnea were “dysfunctional, inconsistent, disorganized and wasteful.” Like many medical groups, SCMG was using a national DME that provided equipment but was out of touch with patient needs. There was little to no follow-up with patients. No data was being collected, poor compliance and expenses were out of control due to dependence on unnecessary and costly resources. Also, the PCPs were not part of a collaborative system, so they were left out of the communication loop. Sharp chose BetterNight as their care management partner because they provided all of the services Sharp needed under one virtual roof. Unnecessary subspecialty consults and in-lab diagnostic studies were replaced with streamlined, PCP driven evaluations and referrals for in-home sleep tests. Compliance doubled, and the budget and spend on OSA could be more easily controlled and predicted. There were excellent patient follow-up and full PCP integration along the care continuum. Dr. Milgram estimates she has saved millions of dollars over the 22-year partnership with BetterNight and has the peace of mind that comes from knowing her patients are well cared for. In referring to how Sharp Community Medical Group is now handling the diagnosis and treatment of sleep apnea patients, Dr. Milgram says with tongue in cheek, “It’s a disease state that I never lose sleep over anymore.”

Having cutting edge software technology has helped BetterNight become a leader in sleep health management. The backbone of BetterNight’s platform is Clarity, their proprietary data analytic software. Information such as patient notes, CPAP usage, sales orders, and sleep study outcomes enter the Clarity engine and are aggregated and updated daily. Using this data, Clarity can target those specific patients who need additional support. As stated by BetterNight’s Dr. Munafo, the result is that BetterNight can reach out to “the right person, at the right time with the right intervention.” Clarity can produce various reports critical for compliance and for connecting all care providers through the care continuum. Detailed reports show where all patients are on their sleep journey and provide a high level of accountability and visibility. Individual reports detail days and hours of CPAP use, treated AHI, and CPAP leak, among other variables. And the broader full population report provides data on apnea severities, modem status, supply orders, and compliance for any given cohort of patients.

By pairing state-of-the-art technology with world-class sleep medicine specialists, BetterNight continues to be the leader in virtual sleep care management. The platform’s streamlined care modules are flexible to fit your practice needs while delivering industry-leading patient outcomes. Having one source to handle the full spectrum of care from diagnosis through treatment provides significant cost savings. It provides ACOs with an excellent opportunity to extend their reach. Sharp Community Medical Group has been saving money and growing with BetterNight for over two decades and serves as an excellent example of the success you and your patients can obtain by partnering with BetterNight.

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