Story casts negative light on sleep testing, say providers

YARMOUTH, Maine -When National Public Radio in January ran a story about the booming sleep apnea business, it caught the ear--and ire--of CPAP providers.

That's because the four-minute story focused on the increasing costs to the healthcare system associated with testing for sleep apnea, using phrases like "lucrative" and "wildly over-prescribed." Lost, say providers, was the benefit associated with getting people tested and treated.

"I think the tone of it was, there's abuse, and there certainly is abuse, but I think they failed to make the case that there's appropriate use of therapy," said Scott Lloyd, president of Extrakare in Norcross, Ga. "This made it sound like there's a bunch of crooks running around between the doctors and the equipment guys."

Although figures for private insurers were not cited, the story did say that Medicare payments for sleep testing increased from $62 million in 2001 to $235 million in 2009, according to the Office of the Inspector General.

But with an aging population, rising obesity levels and increased awareness of sleep apnea, that's to be expected, say providers.

Another factor: "Awareness leads to testing," said Lisa Feierstein, president and co-founder of Active Healthcare in Raleigh, N.C.

Providers also took issue with the oversimplified suggestions--such as losing weight--quoted in the story.

"That's a shortsighted and flippant response, as far as I am concerned," said Feierstein. "They can't lose the weight unless we treat the sleep apnea. They go hand in hand. It's a very complicated issue."

The story also suggests getting more patients diagnosed by home sleep tests, rather than in the more expensive lab setting.

The story's emphasis on the expense of testing, rather than the long-term cost benefits of treatment, was "unhelpful," said Ed Grandi.

"Compliance is where we should be focusing," said Grandi, executive director of the American Sleep Apnea Association. "What are we doing to improve adherence to therapy? Yes, the insurers can get away with paying less for the sleep tests, but they are not going to use the savings to pay for (providers to manage patient compliance)."