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01/12/2022

One step toward repairing the healthcare system

Integrated sleep care can provide a new paradigm for outcomes-focused healthcare

We know there’s room for improvement in the US healthcare system, and a recent analysis by the nonprofit Commonwealth Fund identified many of those deficiencies.

It’s no surprise, but it’s certainly a wake-up call, that the US healthcare system came in last on a variety of measures — from affordability to outcomes — compared to counterparts in 10 other high-income countries. The report underscored the consequences of this stark underperformance, including untreated illness and unnecessary early mortality.

Nox Health recognized the fragmented care, inefficiencies and lack of accountability for outcomes in the treatment of sleep disorders under the traditional system — and we vowed to do better. The SleepCharge program was designed to address this fragmentation and provide transparent, positive outcomes. While our focus is specifically on sleep medicine, our alternative model could serve as a blueprint on a macro level to other areas of healthcare.

Some of the performance measures where the US ranked poorly, according to the report, included:

  • affordability
  • administrative efficiency
  • health outcomes

Let’s look at each of these to see how a sleep program can provide a new paradigm.

Affordability and administrative efficiency
Affordability is a major impediment to seeking care in the US, as is a true understanding of costs. The SleepCharge program aims to make the process simple, transparent and affordable for patients by charging an annual fee for treatment. This charge is not only predictable, it’s often lower than what a patient would pay under the traditional system, where each test, physician visit, piece of equipment and set of supplies is billed separately.

The report’s administrative efficiency ranking refers to how well health systems reduce paperwork and other bureaucratic tasks that patients find to be obstacles to treatment. At SleepCharge, our intake process expedites any needed paperwork, whether for a new patient or one transferring care. When patients opt in to treatment, we submit the claim to their insurance carrier, saving time and removing hassles that distract from focusing on the needed treatment. Plus, having one place for all sleep needs means the patient doesn’t have to navigate a complicated system and possibly fall through the cracks.

Outcomes
Especially startling in the Commonwealth Fund report is that the US ranked last in health care outcomes despite spending more than twice as much of its gross domestic product (17% in 2019) as these other countries.

The SleepCharge program is value-based, which means outcomes reporting is an integral part of our package. We conduct a baseline analysis during client implementation, comparing a client’s existing claims data with a case-matched, non-enrolled population. We provide regular reporting on PAP therapy compliance and other aggregated data and detailed analytics annually to demonstrate a positive impact on health claims, particularly for those with chronic conditions. While we have ample anecdotal evidence from satisfied patients, we know ROI is an important part of measuring performance for our clients.

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The SleepCharge program’s integrated care model focuses on the whole person, making the diagnostic and treatment process affordable, fast and seamless. That’s what leads to healthy outcomes, which is what every patient in the US needs and deserves when it comes to sleep care and overall health care.

 

Sources: Read the Commonwealth Fund report.

Photo by Jacob Lund / AdobeStock

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