|[December 11, 2012]
Anthem Blue Cross and Blue Shield in Missouri Members Save Money, Time through Home Sleep Testing
ST. LOUIS --(Business Wire)--
Anthem Blue Cross and Blue Shield in Missouri members could gain
convenience and potentially save money and time by testing for
obstructive sleep apnea at home while sleeping in their own bed.
In-home tests generally cost $200-$400, which is significantly less than
facility tests in Missouri that range from $789 in an independent
freestanding center to more than $1,555 in a hospital outpatient
"For members who have high-deductible plans or consumer-driven health
plans, this program can be useful in helping them control the portion of
their health care costs they pay directly," said Steve Martenet,
president of Anthem Blue Cross and Blue Shield in Missouri. "The sleep
management program is one of several programs we are putting in place to
help members and employers reduce or maintain costs while still offering
the same quality of services. We are hopeful that these kinds of
programs can also help us in controlling the rise of insurance premiums."
More than 12 million Americans suffer from sleep apnea and many are
undiagnosed, according to the National
Institutes of Health. It's a condition caused by the obstruction of
the upper airway that causes repetitive pauses in breathing during sleep
that can lead to daytime sleepiness or fatigue. Sleep apnea also
increases health risks, such as cardiovascular disease, high blood
pressure, stroke, diabetes, depression, weight gain and obesity.
The Harvard Medical School Division of Sleep Medicine estimated in 2010
that the total annual economic cost of sleep apnea was $65-$165 billion
- greater than asthma, heart failure, stroke and hypertensive disease.
The numbers included costs to diagnose and treat the condition, with a
much larger percentage of the costs derived from hidden health care
costs related to its impact on other diseases and its role in motor
While a home-based test is likely appropriate for 70-80 percent of
patients with suspected sleep apnea, Anthem claims data show only about
1-2 percent of all sleep apnea testing takes place at home, according to
a 2010 analysis by AIM Specialty Health, which is operating the
sleep manageent program. Physicians enter information about their
patient into an AIM web service tool to determine whether an at-home
test is appropriate for their patient.
The June 2012 edition of SLEEP published a research study indicating
that home-based diagnosis and therapy for obstructive sleep apnea in
patients who meet criteria similar to those established in AIM's program
are clinically appropriate in properly selected patients, and achieves
better long-term patient compliance.
For those whose condition is more appropriate for facility testing,
Anthem will contact members and inform them of options for sleep testing
sites that have met accreditation and certification guidelines and
provide competitive prices.
Members can easily set up home sleep tests and sleep in their own beds.
Data is collected by the device and analyzed by technicians and
physicians. Once a member receives a machine used to treat sleep apnea,
equipment vendors can monitor to see how regularly the patient is
wearing the device and follow up with calls to help resolve issues.
"If members are struggling, we want to get them help as soon as possible
so they can get back on track, improve their chances of benefiting from
therapy, and ultimately produce overall better outcomes," said Wayne
Meyer, M.D., medical director at Anthem Blue Cross and Blue Shield in
The program is available now to fully insured and many self-insured
members. Anthem has plans to expand the offering to self-insured groups
About Anthem Blue Cross and Blue Shield in Missouri
In Missouri (excluding 30 counties in the Kansas City area) Anthem Blue
Cross and Blue Shield is the trade name for RightCHOICE® Managed Care,
Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO
Missouri, Inc. RIT and certain affiliates administer non-HMO benefits
underwritten by HALIC and HMO benefits underwritten by HMO Missouri,
Inc. RIT and certain affiliates only provide administrative services for
self-funded plans and do not underwrite benefits. Independent licensees
of the Blue Cross and Blue Shield Association. ®ANTHEM is a registered
trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue
Shield names and symbols are registered marks of the Blue Cross Blue
Shield Association. Additional information about Anthem Blue Cross and
Blue Shield in Missouri is available at www.anthem.com.
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About AIM Specialty Health
AIM Specialty Health or "AIM" is a leading specialty benefit management
company with more than 20 years of experience and a growing presence in
the management of radiology, cardiology, oncology, sleep medicine, and
specialty pharmacy benefits. AIM's mission is to make health care
services more clinically appropriate, safer and more affordable. As
such, it promotes the most appropriate use of specialty care services
through the application of widely accepted clinical guidelines delivered
via an innovative platform of technologies and services. AIM is an
operating subsidiary of WellPoint, Inc. (NYSE: WLP; www.wellpoint.com).
For more information on AIM, please visit www.aimspecialtyhealth.com.
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