Telligen Sleep Apnea Program

June 19, 2015

Did you know sleep apnea affects nearly 43 million Americans and raises the death risk by 46% for those affected? What is more alarming is that 75 percent of severe cases remain undiagnosed.

What is Sleep Apnea?

Sleep apnea occurs when a person stops breathing during sleep. This may occur hundreds of time per night meaning the brain and the body may not get enough oxygen. The two types of sleep apnea are:

  • Obstructive Sleep Apnea which is caused by a blockage of the airway usually when the soft tissue in the back of the throat collapses during sleep
  • Central Sleep Apnea which is caused by failure of brain to send signal to the muscles to breathe

Telligen’s program identifies members with a sleep disorder. With proper identification and treatment, members could expect:

  • Decrease blood pressure readings by 10 points
  • Decrease risk of cardiovascular disease by 37% and stroke by 56%
  • Reduce insulin resistance for improved blood sugar control
  • Improve alertness and motivation which results in eating less and having energy

Sleep Apnea Fast Facts

  • 50% of patients with sleep apnea also have high blood pressure
  • 76% of patients with sleep apnea also have congestive heart failure
  • 48% of patients with sleep apnea also have type 2 diabetes
  • 86% of patients with sleep apnea also are obese

How the Program Works

  1. Determine medical necessity of sleep study test
  2. Decide if sleep study should be done in home or lab (Cost difference of $1,600)
  3. Diagnosis of Obstructive Sleep Apnea confirmed
  4. Pre-certify CPAP machine for 3 month rental
  5. Referral to case management
  6. Case manager collaborates with member and their provider
  7. Health coach receives automated alerts
  8. Health coach monitors adherence and provides coaching to the member
  9. 70% CPAP adherence is meet
  10. Convert from rent to purchase of CPAP machine

Program Success

We are exceeding industry benchmarks for member compliance at 84.2%. (Benchmarks reflect that 70% compliance is great and 80%+ is excellent compliance.)

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