Literature DB >> 32108569

Addressing gaps between payer policies and AASM clinical practice guidelines using scorecards.

Neeraj Kaplish1, Lynn D'Andrea2, R Robert Auger3, Peter Gay4, Ofer Jacobowitz5, Karin Johnson6, Colleen Lance7, Amy Licis8, Susheel Patil9, Michael Summers10, Kunwar Praveen Vohra11, Fariha Abbasi-Feinberg12.   

Abstract

None: The Payer Policy Review Committee of the American Academy of Sleep Medicine launched an initiative to assess the alignment between clinical practice guidelines and private payer medical policies. This article summarizes the importance of the initiative, details the scorecard development process, including an analysis of policy scores and subsequent revisions, and discusses the impact of the scorecards particularly as related to the scorecards on the clinical practice guideline for diagnosis of obstructive sleep apnea in adults. This initiative has increased communication and engagement among members of the Payer Policy Review Committee and private payers, creating opportunities to advocate on behalf of sleep medicine providers and patients with sleep disorders, encouraging payers to modify existing policies so that evidence-based care is provided to patients with sleep disorders.
© 2020 American Academy of Sleep Medicine.

Entities:  

Year:  2020        PMID: 32108569      PMCID: PMC7849807          DOI: 10.5664/jcsm.8410

Source DB:  PubMed          Journal:  J Clin Sleep Med        ISSN: 1550-9389            Impact factor:   4.062


  9 in total

Review 1.  Sleep-disordered breathing and cardiovascular disorders.

Authors:  Rohit Budhiraja; Pooja Budhiraja; Stuart F Quan
Journal:  Respir Care       Date:  2010-10       Impact factor: 2.258

2.  The medical cost of undiagnosed sleep apnea.

Authors:  V Kapur; D K Blough; R E Sandblom; R Hert; J B de Maine; S D Sullivan; B M Psaty
Journal:  Sleep       Date:  1999-09-15       Impact factor: 5.849

3.  Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline.

Authors:  Vishesh K Kapur; Dennis H Auckley; Susmita Chowdhuri; David C Kuhlmann; Reena Mehra; Kannan Ramar; Christopher G Harrod
Journal:  J Clin Sleep Med       Date:  2017-03-15       Impact factor: 4.062

Review 4.  Positive airway pressure treatment for obstructive sleep apnea.

Authors:  Rahul K Kakkar; Richard B Berry
Journal:  Chest       Date:  2007-09       Impact factor: 9.410

5.  Increased prevalence of sleep-disordered breathing in adults.

Authors:  Paul E Peppard; Terry Young; Jodi H Barnet; Mari Palta; Erika W Hagen; Khin Mae Hla
Journal:  Am J Epidemiol       Date:  2013-04-14       Impact factor: 4.897

6.  Meta-analysis of all-cause and cardiovascular mortality in obstructive sleep apnea with or without continuous positive airway pressure treatment.

Authors:  Yiqun Fu; Yunyan Xia; Hongliang Yi; Huajun Xu; Jian Guan; Shankai Yin
Journal:  Sleep Breath       Date:  2016-08-08       Impact factor: 2.816

7.  Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable Monitoring Task Force of the American Academy of Sleep Medicine.

Authors:  Nancy A Collop; W McDowell Anderson; Brian Boehlecke; David Claman; Rochelle Goldberg; Daniel J Gottlieb; David Hudgel; Michael Sateia; Richard Schwab
Journal:  J Clin Sleep Med       Date:  2007-12-15       Impact factor: 4.062

8.  Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort.

Authors:  Terry Young; Laurel Finn; Paul E Peppard; Mariana Szklo-Coxe; Diane Austin; F Javier Nieto; Robin Stubbs; K Mae Hla
Journal:  Sleep       Date:  2008-08       Impact factor: 5.849

Review 9.  The epidemiology of adult obstructive sleep apnea.

Authors:  Naresh M Punjabi
Journal:  Proc Am Thorac Soc       Date:  2008-02-15
  9 in total

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