The Challenge

Diagnose and proactively manage sleep and respiratory conditions at home

Sleep is crucial to health and productivity. Approximately 70 million Americans suffer from sleep disorders. 80% of moderate and severe Obstructive Sleep Apnea (OSA), the most common sleep disorder, goes undiagnosed.2 In addition to $150 billion of lost productivity and increased workplace incidences, with 55-70% comorbidity rate, the cost of untreated sleep apnea also increases the risk of costly health complications such as hypertension, heart disease, diabetes and depression. Diagnosis can require high cost sleep facilities, and even once diagnosed, fewer than 50% of members adhere to their sleep therapy. With current supply chain challenges, ensuring member access to equipment is more challenging than ever.

Are your members getting the sleep help they need?

A comprehensive sleep therapy and respiratory management program benefits health plans by:

  • Redirecting sleep tests to the home when clinically appropriate
  • Increasing therapy adherence with daily monitoring and proactive member engagement
  • Preventing unnecessary overutilization of sleep and respiratory supplies
  • Ensuring on-time starts

Program Results

0 Annual Savings1
0 Redirection Rate to Home Sleep Testing3
0 Member Satisfaction1

Our Approach

As the first sleep benefits manager in the industry, CareCentrix empowers the home with a whole person “diagnosis-to-therapy” approach that addresses four key issues impacting sleep therapy and respiratory management today — care setting, member adherence, and high supply cost and network management.

When appropriate, CareCentrix facilitates at-home sleep testing, closely managing members to follow-through, which greatly improves test completion rates and turnaround times for OSA diagnosis and access to therapy.

Our data-driven sleep management adherence program, iComply, has a team of respiratory therapists and sleep medicine physicians to monitor proper adherence and utilization, and applies real-time data from the member’s PAP device to validate usage, advancing treatment by collaborating with providers to improve therapy success. For members who may still struggle with compliance, we review our device pipeline to recommend alternative therapies and technology to support members in receiving a restful night sleep.

The CareCentrix Value

CareCentrix collaboratively works with providers, payors and members to ensure a high level of support throughout treatment, resulting in a 30% improvement in therapy adherence.4

  • Coordinates the member journey from home-based diagnosis through sleep therapy management
  • Redirects sleep tests to the home when clinically appropriate
  • Facilitates remote monitoring to ensure clinical success
  • Increases therapy adherence through an integrated technology-driven member engagement program
  • Ensures members are set-up in the home by the required start-of-care date and validates that the services are in place