Consumer Health / Monitors / Sleep

News Overview 3.0

Pen and graphs imageOver the years, has followed many exciting developments in the consumer, fitness, health, and sleep monitors markets. Devices, services, and technologies that seemed novel a few years ago are familiar — and often also downloadable as smart phone apps today. That wasn’t always the case, as you’ll see below.

Health Care Reform (July 2009)

While mid-summer Congressional activity winds down, U.S. health care reform continues to be widely discussed in the media. A search of Google news in late July generated more than 25,000 hits, with “top ten” articles from FOX News, the Washington Post, the New York Times, and Business Week. Topics ranged from misrepresentation claims (Obama Administration) to pundits’ opinions about the Blue Dog vote and how proposed plans could impact small business owners.  News from earlier in the month is summarized in the following abstracts.

Long-Term Care Services

In mid-July, two long-term care publications were issued by the SCAN Foundation (Long Beach CA). The National Omnibus Survey on Long-Term Care gauged American opinions and likelihood of supporting specific sets of services. The Long-Term Care in Health Care Reform report includes four policy options, with emphasis on improving access for individuals with limited financial resources and strengthening protections for everyone.

Home care costs have remained fairly stable, but expenditures for assisted living, nursing homes, and Medicaid have risen significantly since 2003. Increasing cost-effectiveness is an obvious option, which may be achievable by shifting some long-term care services from institutions to patients’ homes. Improved coordination of long-term and medical care services is another recommendation.

SCAN Foundation’s survey determined that 80% of Americans were inclined to support inclusion of long-term care in health care reform legislation. As of mid-July, the Senate package included a section for a voluntary insurance program to cover basic home-based long-term care services.

Health Care Success Stories

In mid-July 2009, the U.S. Department of Health and Human Services (HHS) acknowledged the Michigan Keystone ICU Project as a “health care success story.”  As a joint partnership between Johns Hopkins University and the Michigan Health & Hospital Association, measures implemented during the Project greatly reduced catheter-associated infection rates in Michigan ICU departments, generating an estimated cost savings of $200 million. Subsequent HHS reports are planned to showcase other innovative programs and initiatives. [For more information, the original press release is available from HHS.]

Primary Care Physician Shortage

Recent news from Congressional, media, and professional sources identified a workforce shortage of primary care physicians in the United States. With substantial disparities between primary care and specialist salaries, there is little financial incentive for new doctors to work in family and general practices. While health care reform focuses on cost containment and universal coverage, access to care may become a serious issue as more people are insured and demand rises. The Recovery and Reinvestment Act allocated $2.5 billion to encourage doctors to meet primary care needs in rural and other under-served populations. Representatives from professional groups such as the Academy of Family Physicians continue to highlight the problem and advocate for measures to be included in health care reform legislation.

Illinois & North Carolina – Health Reform Initiatives

In a mid-July 2009 press release, the Illinois Academy of Family Physicians (IAFP) announced its support for health care reform. The official statement emphasized the need to combine affordable, high quality health care to everyone while maintaining patients’ choice of plans and primary care physicians. The IAFP supports the U.S. Senate legislation (the Affordable Health Choices Act). [The original press release was issued by the Illinois Academy of Family Physicians.]

North Carolina state employees joined the Service Employees International Union (SEIU) to demonstrate their support of health care reform. The group designated July 15th, 2009 as “We Can’t Wait for Affordable Health Care” day and advocates for a plan that lowers costs while also providing quality care for all. The event took place at Blue Cross Blue Shield (Chapel Hill) because the company has a 72.5% market share in North Carolina. Current estimates suggest that approximately 1.8 million North Carolinians are uninsured.

Sleep Disorders (May 2008)

Those who don’t have problems sleeping probably take it for granted.  Besides the obvious after-effects (drowsiness, fatigue, etc.), conditions such as sleep apnea are associated with an increased risk for cardiovascular disease, heart failure, myocardial infarction, and stroke.  Sleep apnea is associated with brain signals that initiate throat muscle relaxation.  As the airway gets blocked, patients must wake up to breathe.

Medicare Approval Of In-Home Sleep Testing Studies

Sleep disorder testing typically involves an overnight stay in a sleep lab. In addition to the time and expense, patients may wait months to get an appointment. Medicare’s recent ruling to approve use of Type II, Type III, and Type IV in-home testing devices is expected to speed up diagnosis and treatment for sleep apnea patients. Detailed information about testing requirements has not yet been released, but industry analysts expect local coverage determinations will solve that issue at a later date.

In-home testing is generally considered to be accurate if competently administered.  Consumers are likely to benefit from the new Medicare ruling. Treatment payment based on an in-home study and diagnosis will be limited to three months, after which documented treatment effectiveness will ensure ongoing reimbursement.

Sleep Deprivation & Brain Shutdowns

A study published recently in the Journal of Neuroscience associates sleep deprivation with “brain shutdowns” (a hovering between sleep and wakefulness). Researchers at the University of Pennsylvania’s School of Medicine who identified the condition noted that more structural changes are taking place during the shutdowns than had been seen or expected.  Even one night of sleep deprivation may result in dramatic temporary lapses in attention and visual processing capabilities. [For more information, visit: Advanced Sleep & Breathing Disorders]

Sleep Apnea Risk For Stroke Victims

Findings from two new studies identified increased risks associated with obstructive sleep apnea (OSA) for certain types of patients. According to research conducted by a Swedish team, stroke victims with OSA died sooner than those who did not have the sleep disorder.  A total of 132 stroke patients were studied for ten years, with those who had the greatest obstructive apnea-hypopnea index showing the highest likelihood of an early death.

With a larger patient pool, Spanish researchers noted that treating OSA with continuous positive airway pressure for five or more hours a night helped patients with hypertension lower their blood pressure.  Results from both studies were presented at the 2008 International Conference of the American Thoracic Society (Toronto, Canada). [The original article was published in the The Atlanta Journal-Constitution.]

Consumer-Driven Health Care (September 2008)

Shopping for health care is a difficult proposition, since patients are rarely able to evaluate prices before receiving medical services. Consumer-driven health care is a self-directed payment model that provides financial incentives and information to support the decision-making process as an alternative to conventional health insurance. The following news abstracts highlight recent developments.

Fewer Consumer-Driven Health Plans Offered By Employers In Iowa

As reported in August by the Des Moines Register, data from David P. Lind & Associates show that Iowa employees and employers experienced a nearly 9% average increase in insurance costs in 2008.  Iowa’s largest health insurer, Wellmark Blue Cross Blue Shield, has experienced ongoing demand for its offerings. Next year, Great River Health Systems (Burlington IA) will be testing consumer-driven health plans with a select group of hospital employees to determine if the change will save money for its self-funded health care plan.

A critical factor for employees who are considering consumer-driven health care plans is whether or not there is a financial benefit over conventional insurance.  Higher deductibles are one area for concern.  The Lind report tracked an 80% rise in premium costs for single workers during the past eight years, from $2,377 in 2000 to $4,276 in 2008.  During the same time period, deductibles have more than tripled for all employees (with single or family plans).

Some employers (13% of respondent companies) have turned to wellness as a way to encourage employees to adopt healthier lifestyles. For example, Grinnell Mutual Reinsurance (Grinnell IA) established a pilot program that helps employees set “personalized” health goals.

New Survey Forecasts Slower Growth In U.S. Health Care Costs

Employers expect a nearly 11% increase in insurance costs this coming year, according to a report from Aon Consulting Worldwide published in August 2008.  Surprisingly, the 10.6% is similar to the level seen in 2007 but lower than the 15% – 16% gains posted in 2001 and 2002.  As noted in an article from SFGate, rising costs can be curtailed by 3% to 4% when employers implement disease management and wellness programs.  A study published by PriceWaterhouseCoopers forecasts a 10% insurance cost increase in 2009. An estimated 25% of private payers’ expenditures will cover the uninsured and underpayments by Medicaid, Medicare, and other government programs.

The Venture Capital Contribution To Health Care Innovation

Highlighting the role of venture capital in new markets, an article in the Minneapolis-St. Paul Star Tribune profiled the dynamic founder of Definity Health, Tony Miller. Venture capitalists are able to take advantage of opportunities to “disrupt” conventional markets by developing new models.  According to Mr. Miller, consumer-driven health care is one way to change the current U.S. health care system.  For example, while employers complain about paying for health care plans, the costs are part of employees’ compensation packages.  In 1999, Definity Health introduced the revolutionary idea of establishing health savings accounts (e.g., consumer-driven health care) which enabled individuals to pay their own medical bills with an option that also fit within the existing system.  Definity is now a subsidiary of UnitedHealth.  Since divesting Definity, Mr. Miller founded a new company (Lemhi) to promote innovative health care business models.

Personal Health Monitors (January 2008)

For disease-related testing (e.g., blood pressure monitors) or fitness monitoring (e.g., pedometers and health management software), consumers can choose from a wide variety of products. As one industry observer notes, many people are swapping wristwatches for wearable devices such as heart rate monitors and using cell phones to keep track of the time.

Silicon Microstructures Supplies MEMS Array To Omron Healthcare

The market for blood pressure monitors benefits from sensor technology developments.  For its new pulse wave transient blood pressure measurement products, Omron Healthcare selected Silicon Microstructures as a development partner and supplier.  Silicon Microstructures’ radial Augmentation Index is an advanced method of providing accurate non-invasive arterial and cardiac measurements that can be incorporated into Omron’s new blood pressure sensing solutions. [The original press release was issued January 18th, 2008 by Market Wire: “Silicon Microstructures Strengthens Its Position in the Medical MEMS Market.”]

Indiana Is Ranked Among The Top Ten “Medical Technology” States

The Advanced Medical Technology Association’s new study ranked Indiana among the top ten states, based on the number of people employed and new jobs created within the medical technology field. Examples of products that fit the category are: Blood pressure monitors, eyeglasses, heart pacemakers, hospital equipment, imaging systems, kidney dialysis machines, replacement joints, and stethoscopes. Indiana manufacturers in the Purdue Research Park include Bioanalytical Systems Inc., Cook Biotech Inc., and Endocyte Inc. Specifically, Indiana ranked second nationwide in the number of jobs created (63,000 employed in the medical technology industry) and fifth in per-capita employment. The findings highlight medical technology’s sustained momentum in Indiana and also offer an opportunity for global recognition of the state’s achievement. [The original article was published by Journal and Courier Online.]

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