AIS Newsletter Reports on Strategies Blues Plans Are Implementing to Combat Sleep Apnea

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For its December issue, The AIS Report on Blue Cross and Blue Shield Plans* spoke with officials with Highmark and WellPoint on the strategies the two insurers are using to combat sleep apnea, ranging from brick-and-mortar retail stores to data collection from CPAP machines.

For its December issue, Atlantic Information Services, Inc.’s (AIS) independently published The AIS Report on Blue Cross and Blue Shield Plans* interviewed officials at Highmark Inc. and WellPoint, Inc. on the varied strategies the two Blues plans are implementing in order to lower costs and improve compliance with treatments for sleep apnea, ranging from brick-and-mortar retail stores to patient data collection. The sleep disorder, because it’s linked to increased rates of a variety of serious disorders, including hypertension, stroke and diabetes, can create massive costs for insurers.

Highmark’s Business Innovation and Development department is opening what it calls a “first-of-its-kind” retail store to help people sleep better. The REMWorks Sleep Store, which will open in an upscale open-air mall outside Pittsburgh, will feature a spa-like environment and products ranging from prescription continuous positive airway pressure (CPAP) machines and masks, to aromatherapy solutions. Store personnel — who will include respiratory therapists, sleep lab technicians and a registered nurse — will “engage more with the customer and really help them to see this can be life-changing and a lifetime benefit,” store Director Amy Phillips told The AIS Report. Highmark is starting with one store, but Phillips says she can see additional stores coming online relatively quickly if this one proves successful. “We’ll know within a year — this time next year we’ll be making a decision” on whether to expand.

AIM Specialty Health, a specialty benefits management subsidiary of WellPoint, Inc., is focusing on compliance in an effort to reduce overall health costs associated with untreated or undertreated sleep apnea. By collecting CPAP data from machines, AIM will be able to identify noncompliant patients and refer them to disease management nurses within their health plans, Tom Power, M.D., medical director for AIM, says. Although AIM doesn’t currently interact directly with patients, “another option could be with health plan consent, reaching out to patients directly, or to their providers,” he says. AIM is also considering research into the “surprising number” of patients who have a sleep study ordered but have not had it done, in order to pinpoint patients’ reasons for skipping the study or the therapy, he says. “For example, if we were to find that the reason people didn’t have the study was because of the copayment, it might be advisable to change the benefit design,” he says.

Visit http://aishealth.com/archive/nblu1214-02 to read the article in its entirety.

About The AIS Report on Blue Cross and Blue Shield Plans*
The AIS Report on Blue Cross and Blue Shield Plans delivers timely news and insightful analysis of new products, market share, strategies, conversions, financing, profitability and strategic alliances of Blue Cross and Blue Shield plans, which are major players in every U.S. health insurance market. The 12-page monthly newsletter is designed for plan managers and others who consider BCBS plans to be partners or competitors. Visit http://aishealth.com/marketplace/ais-report-blue-cross-and-blue-shield-plans for more information.

*A thoroughly objective publication, The AIS Report on Blue Cross and Blue Shield Plans is published independently by AIS and is not affiliated with or sponsored, endorsed or approved by the Blue Cross and Blue Shield Association or any of the independent Blue Cross and Blue Shield companies.

About Atlantic Information Services
Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for more than 25 years. It develops highly targeted news, data and strategic information for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, websites, looseleafs, books, strategic reports, databases, webinars and conferences. Learn more at http://AISHealth.com.

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