| If you haven't heard, Medicare and private insurers | | | | rather can tweak our therapy if something is not |
| are putting the screws to the Durable Medical | | | | working, and quantify the results of the tweak. |
| Equipment companies (DMEs) that provide our CPAP | | | | Now the reason the dumb machines were put out |
| supplies in an effort to cut costs, much to the | | | | there in the first place was because the DMEs could |
| chagrin of the DME providers. One aspect of the | | | | get away with it. Not any longer. Insurers are saying |
| cost-cutting is to deny reimbursement to DMEs and | | | | you have to give out data capable machines, |
| other providers that cannot show that their patients | | | | because there is no other way you can prove to us |
| are complying with CPAP treatment. While at first | | | | that the machines are being used and unless we |
| blush, this might seem like an adverse development | | | | have that proof, we're not going to reimburse you |
| for us patients, the problem for us might be that the | | | | for it. And look what the result is: chances are slim |
| insurers didn't do this sooner, and that they haven't | | | | that any Sleep Apnea newbie is being prescribed a |
| yet gone far enough. | | | | machine that doesn't at least have some basic data |
| My thinking is this: for too long, DMEs could get away | | | | capability. |
| with giving out to patients the most basic, least | | | | But let's not rest on our laurels. That's a step in the |
| effective and "dumbest" machines out there. These | | | | right direction, but just a baby step. What we are |
| are the machines that cost the DMEs the least (and | | | | really after with data monitoring isn't just knowing |
| result in the greatest profit margin), but which also | | | | that the machine is on, but knowing that it is being |
| reduce the likelihood of us getting well with Sleep | | | | effective. So I would advocate that the insurers |
| Apnea. With no feedback given to the patient on | | | | make the DMEs reimbursement conditioned on |
| how the patient is doing, the patient quickly kicks | | | | efficacy data, and not just compliance data. My |
| aside the treatment altogether when something goes | | | | guess is after a little while with this regime in place, |
| wrong, because there is no obvious path to fix the | | | | we'll see a big move forward in patient compliance |
| problem. As we know, data-capable machines provide | | | | rates, and in innovative technology designed to |
| this feedback so that we are not "flying blind," but | | | | improve compliance. |