A quick chat with Ed Grandi

I heard from Ed Grandi this week. You remember Ed. He was the executive director for the American Sleep Apnea Association for years until he stepped down this spring. He called about an article we recently published that would increase sleep apnea screening requirements for Medicare patients.

The providers in the story thought, by and large, that the idea was a positive, but pointed out that there are so many rules and regulations that come with getting the equipment to the patient that increasing screening doesn't translate automatically into testing and treatment.

And, of course, with any increase in diagnosis, there's an increase in utilization. In Medicare's eye, that means there's a problem. That strikes fear in the heart of providers who wake up screaming in the night over audits.

It's all part of a pattern of not seeing the big picture, Ed told me. The policy wonks (my words, not Ed's) don't grasp the concept of spending on the front end to save on the back end. That's especially true of a condition like sleep apnea, which has a host of a$$ociated co-morbiditie$$$.

Ed then asked for information about the binding bid bill that was introduced just last week. I explained that, while the industry would love to see the bidding program go away, that's simply not going to happen. Carving out a couple of bits from the bigger bill that are far more likely to pass is likely the best shot right now at making the program, if not disappeared, at least more palatable.

Until we get to the point where we have enough evidence that the program is causing problems for beneficiaries, smaller steps won't hurt, he said.

"This will allow us to nibble around the edges," Ed told me.