sleep market panel - resmed · sleep market panel ©resmed 2014 i 2 ... dispense therapeutic sleep...

Results for June 2014

Sleep Market Panel

©ResMed 2014 I 2

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

Notes:

©ResMed 2014 I

Panel Member Profile, June‘14

o In June, a total of 152 labs from 37 states submitted their data (12 are new

panel members)

8% 7% 3% 9%

15% 10%

15% 6% 7% 7% 4% 5%

67% 65% 65%

66% 52% 54%

57%

55% 57% 56% 57% 52%

25% 28% 32% 25%

33% 36% 28%

39% 36% 37% 40% 43%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

July Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun

Sleep Lab Business Model Trend

Independent/Stand AloneAffiliated with HospitalAffiliated with Hospital and Managed by outside entity

Note: No representation from Alaska or Hawaii

June 2014 Data Collected from 37 States

State Represented in June

Not Represented

3

©ResMed 2014 I

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

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'14

0

5

10

15

20

25

85% of sleep labs have ≤ 6 beds

Nu

mb

er B

ed

s p

er

Sle

ep

Lab

Distribution of Beds per Sleep Lab

20% 17%

20% 23%

19% 20% 19% 16% 16% 16%

18%

13%

0%

5%

10%

15%

20%

25%

30%

35%

40%


Percent of Sleep Labs Dispensing Sleep Apnea Equipment

4

©ResMed 2014 I

Sleep Labs Planning to Add Beds Next Month

o 5% of total labs plan to add more

beds to their facility in June

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

0%

3%

0%

6%

4% 3%

1%

2%

0%

2% 2%

3%

0% 0%

10%

0%

5% 6%

5% 4%

2%

3%

2%

7%

0%

2%

3% 3%

4% 4%

2%

3%

1%

2% 2%

5%

-2%

0%

2%

4%

6%

8%

10%

12%

Sleep Labs Adding Beds Next Month By Business Model

Hospital Labs Inpedendent Labs All Labs

Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun

5

©ResMed 2014 I

Split-Night Studies and Auto-scoring

o In June, 20% of overnight tests

were conducted as split-night

studies

o The percent of split-night

studies conducted over the last


averaged 22%

o In June, 13% of labs reported

using Auto-scoring or

Computer Assisted Scoring

o The percent of labs using Auto-

scoring over the last 12 months

Jul'13 - Jun'14 averaged 14%

15% 13%

17%

12% 14%

12% 15% 14%

12% 16%

14% 13%

0%

5%

10%

15%

20%

25%

30%

35%

40%


Percent of Sleep Labs Utilizing Auto-scoring Software

22% 21% 23% 22% 23%

26% 22% 23% 22% 21% 22%

20%

0%

5%

10%

15%

20%

25%

30%

35%

40%


Overnight Tests Conducted as Split-Night Studies

6

©ResMed 2014 I

Volume of In-lab Overnight Sleep Testing Per Bed

o In June, labs conducted an

average of 14 in-lab overnight

tests per bed, with a range of

1-30

o The number of tests

conducted per bed in the last


averaged 14

0

5

10

15

20

25

30

35

40Distribution of # Overnight Studies per Bed

Average tests per bed = 14

# St

ud

ies

pe

r B

ed

13 15

13

16 14

13 13 12

13 14 14 14

0

5

10

15

20


Average Monthly In-Lab Tests Per Bed #

Stu

die

s p

er

Bed

7

©ResMed 2014 I

Home Sleep Testing (HST)

59% 55%

60%

57% 59%

62% 63%

60%

65% 62%

64% 67%

40%

45%

50%

55%

60%

65%

70%

75%

80%


Sleep Labs Conducting Home Sleep Testing 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

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

6% 6%

12%

6% 6% 7%

8% 8% 8% 10% 10%

9%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%


HST as a Percentage of Total Test Volume

8

©ResMed 2014 I

Average Monthly Testing Volume Conducted Per Lab

(In-Lab + HST): By Business Model

71

80

74

88

73 74

68

59 70

74 74

79 85

100

87 95

81 79

60 54

74 78 83

74 74

81 79

90

76 76

65

57

71 76 78 77

20

40

60

80

100

120

140


# o

f To

tal S

lee

p T

est

s

Total Volume of Sleep Tests Conducted Hospital Labs vs. Independent Labs

Hospital Lab Independent Lab All Sleep Labs

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: 75

9

©ResMed 2014 I

Average Monthly Testing Volume Conducted Per Lab

(In-Lab + HST): HST vs. Non-HST Labs

95

118

103

111

97

80 79

65

87

94 95 95

44 47

39

54

46

69

42 43 43 45 47 42

74

81 79

90

76 76

65

57

71 76 78 77

20

40

60

80

100

120

140


# o

f To

tal S

lee

p T

est

s

Total Volume of Sleep Tests Conducted Labs Conducting HST vs. Non- HST Labs

HST Labs Non-HST Labs All Sleep Labs


total sleep tests were: – HST Labs: 95

– Non-HST Labs: 42

– All Labs: 77



Jul'13 - Jun'14 averaged: – HST Labs: 93

– Non-HST Labs: 47

– All Labs: 75

10

©ResMed 2014 I

Average Monthly Volume of In-Lab Tests vs. HSTs Conducted Per

Lab

70

81

70

85

71 70

60

52

66 68 70 70

4

5

9

6

4 5

5

5

6 7

8 7

0

10

20

30

40

50

60

70

80

90

100


# o

f Sl

ee

p T

est

s b

y Te

st M

eth

od

Total Volume of Sleep Tests Conducted

HST

In-Lab


sleep tests per lab by test

method: • In-Lab: 70

• HST: 7



Jul'13 - Jun'14 averaged: – In-Lab: 69

– HST: 6

11

©ResMed 2014 I

Volume of In-lab Sleep Tests Conducted Per Lab

73 70

81

70

85

71 70

60

52

66 68

70 70

58 60

55 54

65

56 56

48 43

53 57

54 54

10

20

30

40

50

60

70

80

90

100

June July Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun

# o

f O

vern

igh

t Sl

ee

p T

est

s P

lus

HST

Volume of In-Lab Testing Per Lab

Mean

Median

o In June, the number of sleep

In-lab tests per lab: • Mean: 70

• Median: 54

• Range: 4-279

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)

12

©ResMed 2014 I

Volume of Home Sleep Testing

7

9

15

9 8 8

9

8 9

12 13

11

5 6

5 4 4

5 6

5 5

7 6

8

2

4

6

8

10

12

14

16

Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun

Avg

. # o

f H

om

e Sl

eep

Tes

ts C

on

du

cted

Volume of Home Sleep Testing Per Lab

Mean

Median

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)

Range of Home Sleep Studies Conducted Per Lab

Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr Jun Jul

1-25 1-30 1-436 1-114 1-32 1-35 1-33 1-67 1-45 1-56 1-160 1-60

Base: Labs conducting HST

13

©ResMed 2014 I 14

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

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 0%-83%

Volume of Patient Cancellations

Distribution of Cancellations as % of Total Tests Conducted

Can

cella

tio

ns

as %

of

Tota

l Te

sts

Co

nd

uct

ed

“Cancellation” is defined as an appointment

that is dropped and not rescheduled.

Average cancellations as a

percentage of studies = 13%

©ResMed 2014 I

PAP Device Scripting

o In June, 40% of sleep studies resulted in

a script for a PAP device

68%

19%

12%

PAP Device Scripting Split

CPAP APAP Bilevel

15

©ResMed 2014 I

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

• Among those labs, an

average of 64% of studies

required pre-authorization,

with a range of 7-100%

57% 53% 53% 56% 55% 55% 53% 54% 55% 54% 54% 55%

31% 32% 35% 32% 32% 32% 33% 33% 31% 32% 32%

31%

9% 13% 10% 11% 11% 11% 12% 11% 13% 12% 12% 13%

2% 2% 2% 1% 2% 2% 2% 1% 1% 2% 2% 1%

Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Billing Split Private insurance Medicare Medicaid Out of pocket

©ResMed 2014 I 17

oMonthly 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”

Month-to-Month Trending

Jul-Aug

Aug-Sep

Sep-Oct

Oct-Nov

Nov-Dec

Dec-Jan

Jan-Feb

Feb-Mar

Mar-Apr

Apr-May

May-Jun

Jun-Jul

Number of Repeat Panel Members

54 57 65 77 88 89 95 116 110 111 127 118

©ResMed 2014 I

Month-to-Month Changes in Volume of In-lab Overnight Sleep Testing

-1%

3%

-10%

11%

-7% -3%

-6% -7%

16%

4%

-2%

3%

-50%

-40%

-30%

-20%

-10%

0%

10%

20%

30%

40%

50%

Volume of In-Lab Sleep Testing Month-to-Month % Change

% M

on

th-t

o-M

on

th C

han

ge

o For repeat panel members,

the volume of in-lab sleep

testing increased by 3%

from Jun'13 - Jun'14

o There was a no change in

monthly testing volume

over the last 12 months

Jul'13 - Jun'14

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

©ResMed 2014 I

Month-to-Month Changes in Volume of Home Sleep Testing

5%

26%

11%

6% 6%

13% 10%

1%

16% 17%

3%

-3%

-50%

-40%

-30%

-20%

-10%

0%

10%

20%

30%

40%

50%

Volume of Home Sleep Testing Month-to-Month % Change

% M

on

th-t

o-M

on

th C

han

ge


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'14

19


©ResMed 2014 I

Month-to-Month Changes in Volume of Patient Cancellations

-14%

-3%

0%

-8%

-2%

12%

-14%

1%

10%

1% 4%

0%

-50%

-40%

-30%

-20%

-10%

0%

10%

20%

30%

40%

50%

Volume of Patient Cancellations Month-to-Month % Change

% M

on

th-t

o-M

on

th C

han

ge

o For repeat panel

members, there was no

change in the number of

cancellations from Jun'13

- Jun'14

o There was a 1% decrease

in cancellations on

average in the last 12

months, Jul'13 - Jun'14

20


©ResMed 2014 I

Month-to-Month Changes in % of Sleep Studies Resulting in Scripts

-4%

3% 1% 2%

-8%

0%

-2% -7%

0%

7% 8%

1%

-50%

-40%

-30%

-20%

-10%

0%

10%

20%

30%

40%

50%

Month-to-Month Change in the % of Sleep Studies Resulting in Scripts

% M

on

th-t

o-M

on

th C

han

ge

o For repeat panel

members, there was a 1%

increase in the percent of

sleep studies resulting in

scripts from Jun'13 -

Jun'14

o 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'14

21


©ResMed 2014 I

Month-to-Month Change in PAP Device Scripting Split

-12%-11%-10%

-9%-8%-7%-6%-5%-4%-3%-2%-1%0%1%2%3%4%5%6%7%8%9%

10%11%12%

Month-to-Month Change in PAP Scripting Split

CPAP

APAP

Bilevel


the PAP scripting changed as

follows from Jun'13 - Jun'14:

• CPAP increased by 3%

• APAP decreased by 2%

• Bilevel decreased by 1%

Mo

nth

-to

-Mo

nth

Ch

ange

22


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