Sleep Market Panel. Results for June 2014
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- Jordan Virgil Tate
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1 Sleep Market Panel Results for June 2014
2 Notes: o This is a monthly trending report of panel member data along with additional analysis by: Sleep labs affiliated with Hospitals vs. Independent Labs o Hospital - Labs affiliated with hospitals o Independent - Labs that are stand alone entities Sleep labs conducting HSTs vs. Non-HST labs o HST - Labs reported conducting at least ONE home sleep test a month o Non-HST - Labs reported conducting NO home sleep tests 2
3 Panel Member Profile, June 14 o In June, a total of 152 labs from 37 states submitted their data (12 are new panel members) June 2014 Data Collected from 37 States 10 Sleep Lab Business Model Trend % 28% 32% 25% 33% 36% 28% 39% 36% 37% 4 43% % 65% 65% 66% 52% 54% 57% 3 55% 57% 56% 57% 52% 2 State Represented in June Not Represented Note: No representation from Alaska or Hawaii 1 8% 7% 3% 9% 15% 1 15% 6% 7% 7% 4% 5% July Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Independent/Stand Alone Affiliated with Hospital Affiliated with Hospital and Managed by outside entity 3
4 Number Beds per Sleep Lab Panel Member Profile, June 14 o Lab sizes ranged from 1 18 beds, with an overall average of 4.9 beds and a median of 4 beds Distribution of Beds per Sleep Lab 85% of sleep labs have 6 beds 5 0 o In June, 13% of labs dispense therapeutic sleep apnea equipment to patients o The percentage of labs dispensing sleep equipment averaged 18% in the last 12 months Jul'13 - Jun' % 3 25% 2 15% 1 5% Percent of Sleep Labs Dispensing Sleep Apnea Equipment 23% % 2 19% 17% 18% 16% 16% 16% 13% July Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun 4
5 Sleep Labs Planning to Add Beds Next Month o 5% of total labs plan to add more beds to their facility in June 12% Sleep Labs Adding Beds Next Month By Business Model o The percentage of total labs planning to add beds in the next month averaged 3% in the last 12 months Jul'13 - Jun'14 1 8% 6% 4% 2% 3% 2% 1 6% 3% 3% 6% 5% 4% 4% 4% 3% 5% 2% 1% 4% 3% 2% 2% 1% 3% 2% 2% 2% 7% 5% 3% -2% Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Hospital Labs Inpedendent Labs All Labs 5
6 Split-Night Studies and Auto-scoring o In June, 2 of overnight tests were conducted as split-night studies o The percent of split-night studies conducted over the last 12 months Jul'13 - Jun'14 averaged 22% 4 35% 3 25% 2 15% 1 5% Overnight Tests Conducted as Split-Night Studies 22% 21% 23% 22% 23% 26% 22% 23% 22% 21% 22% 2 July Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun o In June, 13% of labs reported using Auto-scoring or Computer Assisted Scoring o The percent of labs using Autoscoring over the last 12 months Jul'13 - Jun'14 averaged 14% 4 35% 3 25% 2 15% 1 5% Percent of Sleep Labs Utilizing Auto-scoring Software 17% 15% 13% 14% 15% 14% 16% 14% 12% 12% 12% 13% July Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun 6
7 # Studies per Bed # Studies per Bed Volume of In-lab Overnight Sleep Testing Per Bed 40 Distribution of # Overnight Studies per Bed o In June, labs conducted an average of 14 in-lab overnight tests per bed, with a range of Average tests per bed = o The number of tests conducted per bed in the last 12 months Jul'13 - Jun'14 averaged Average Monthly In-Lab Tests Per Bed July Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun 7
8 Home Sleep Testing (HST) o In June, 67% of labs conducted portable, at-home sleep studies Among those conducting home testing, an average of 98% at-home studies were billed to insurance per month 8 75% 7 65% 6 55% 59% Sleep Labs Conducting Home Sleep Testing 6 62% 63% 65% 64% 62% 55% 57% 59% 6 67% o The percentage of sleep labs conducting home sleep tests has been increasing, averaging 61% in the last 12 months o In June, Home Sleep Testing was 9% of the total testing volume 5 45% % 16% 14% 12% 1 8% 6% 4% 2% July Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun HST as a Percentage of Total Test Volume 12% 1 1 8% 8% 9% 8% 6% 6% 6% 7% 6% July Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun 8
9 Average Monthly Testing Volume Conducted Per Lab (In-Lab + HST): By Business Model # of Total Sleep Tests o In June, the average number of total sleep tests were: Hospital Labs: 79 Independent Labs: 74 All Labs: 77 o The number of tests conducted per lab in the last 12 months Jul'13 - Jun'14 averaged: Hospital Labs: 74 Independent Labs: 79 All Labs: Total Volume of Sleep Tests Conducted Hospital Labs vs. Independent Labs July Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Hospital Lab Independent Lab All Sleep Labs 9
10 # of Total Sleep Tests Average Monthly Testing Volume Conducted Per Lab (In-Lab + HST): HST vs. Non-HST Labs o In June, the average number of total sleep tests were: 140 Total Volume of Sleep Tests Conducted Labs Conducting HST vs. Non- HST Labs HST Labs: 95 Non-HST Labs: 42 All Labs: o The number of tests conducted per lab in the last 12 months Jul'13 - Jun'14 averaged: HST Labs: Non-HST Labs: 47 All Labs: July Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun HST Labs Non-HST Labs All Sleep Labs 10
11 # of Sleep Tests by Test Method Average Monthly Volume of In-Lab Tests vs. HSTs Conducted Per Lab o In June, the average number of sleep tests per lab by test method: In-Lab: 70 HST: Total Volume of Sleep Tests Conducted o The number of tests conducted per lab in the last 12 months Jul'13 - Jun'14 averaged: HST In-Lab In-Lab: HST: July Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun 11
12 # of Overnight Sleep Tests Plus HST Volume of In-lab Sleep Tests Conducted Per Lab o In June, the number of sleep In-lab tests per lab: 100 Volume of In-Lab Testing Per Lab Mean: 70 Median: 54 Range: o The average number of tests conducted per lab in the last 12 months Jul'13 - Jun'14 was 70 (with a median of 70) Mean Median June July Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun 12
13 Avg. # of Home Sleep Tests Conducted Volume of Home Sleep Testing o Among those conducting home testing in June, the number of sleep tests conducted per lab: Mean: 11 Median: 8 Range: 1-60 o The average monthly number of home tests conducted per lab in the last 12 months, Jul'13 - Jun'14 was 10 (with a median of 9) Volume of Home Sleep Testing Per Lab Mean 7 8 Median Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Base: Labs conducting HST Range of Home Sleep Studies Conducted Per Lab Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr Jun Jul
14 Cancellations as % of Total Tests Conducted Volume of Patient Cancellations o In June, cancellations per lab averaged 8, with a range of 0-71 per lab o Cancellations per bed averaged 1.6 with a range of 0-15 per bed o Cancellations as a percentage of studies conducted averaged 13%, with a range of -83% Distribution of Cancellations as % of Total Tests Conducted Average cancellations as a percentage of studies = 13% 2 1 Cancellation is defined as an appointment that is dropped and not rescheduled. 14
15 PAP Device Scripting o In June, 4 of sleep studies resulted in a script for a PAP device PAP Device Scripting Split CPAP APAP Bilevel 12% 19% 68% 15
16 Billing o In June, 55% of sleep studies were billed to private health insurance and 31% were billed to Medicare (traditional and/or managed) o 37% of labs reported tracking insurance pre-authorizations % 2% 2% 1% 2% 2% 2% 1% 1% 2% 2% 1% 9% 13% 1 11% 11% 11% 12% 11% 13% 12% 12% 13% 31% 32% 35% 32% 32% 32% 33% 33% 31% 32% 32% 31% Among those labs, an 5 average of 64% of studies required pre-authorization, 4 with a range of % 53% 53% 56% 55% 55% 53% 54% 55% 54% 54% 55% 2 1 Billing Split Private insurance Medicare Medicaid Out of pocket Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun
17 Month-to-Month Trending o Monthly comparisons (month-to-month percent change) can only be made using data from the exact same sleep labs. o In the slides that follow, we refer to sleep labs who provided their data for 2 months in a row as repeat panel members Number of Repeat Panel Members Jul- Aug Aug- Sep Sep- Oct Oct- Nov Nov- Dec Dec- Jan Jan- Feb Feb- Mar Mar- Apr Apr- May May- Jun Jun- Jul 17
18 % Month-to-Month Change Month-to-Month Changes in Volume of In-lab Overnight Sleep Testing o For repeat panel members, the volume of in-lab sleep testing increased by 3% from Jun'13 - Jun' Volume of In-Lab Sleep Testing Month-to-Month % Change o There was a no change in monthly testing volume over the last 12 months Jul'13 - Jun' % 3% -1 11% -7% -3% -6% -7% 16% 4% -2% 3% Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun 18
19 % Month-to-Month Change Month-to-Month Changes in Volume of Home Sleep Testing o For repeat panel members, the volume of home sleep testing decreased by 3% from Jun'13 - Jun'14 o There was a 9% increase in monthly testing volume over the last 12 months Jul'13 - Jun' % 26% Volume of Home Sleep Testing Month-to-Month % Change 11% 6% 6% 13% 1 1% 16% 17% 3% -3% Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun 19
20 % Month-to-Month Change Month-to-Month Changes in Volume of Patient Cancellations o o For repeat panel members, there was no change in the number of cancellations from Jun'13 - Jun'14 There was a 1% decrease in cancellations on average in the last 12 months, Jul'13 - Jun' % -3% Volume of Patient Cancellations Month-to-Month % Change -8% -2% 12% -14% 1% 1 1% 4% Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun 20
21 % Month-to-Month Change Month-to-Month Changes in % of Sleep Studies Resulting in Scripts o o For repeat panel members, there was a 1% increase in the percent of sleep studies resulting in scripts from Jun'13 - Jun'14 In the last 12 months on average, there was a 1% decrease in the percent of sleep studies resulting in a script, Jul'13 - Jun' % Month-to-Month Change in the % of Sleep Studies Resulting in Scripts 3% 1% 2% -8% -2% -7% 7% 8% 1% -5 Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun 21
22 Month-to-Month Change Month-to-Month Change in PAP Device Scripting Split o For repeat panel members, the PAP scripting changed as follows from Jun'13 - Jun'14: CPAP increased by 3% APAP decreased by 2% Bilevel decreased by 1% 12% 11% 1 9% 8% 7% 6% 5% 4% 3% 2% 1% -1% -2% -3% -4% -5% -6% -7% -8% -9% -1-11% -12% Month-to-Month Change in PAP Scripting Split CPAP APAP Bilevel Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun 22
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