Downstream Impact of a Sleep Surgery Program; Optimizing Patient Care and Generating Clinical Volume

In recent years, a growing number of Otolaryngologists have incorporated the management of sleep disorders into their practice. We aim to assess the downstream impact of a Sleep Surgery division within a department of Otolaryngology.

We assess all new patients with a diagnosis of sleep apnea presenting to our division of Sleep Surgery, consisting of two surgeons, from January 1, 2021 through December 31, 2021. Our outcome measures included testing and procedures that occurred because of our workup of new patients presenting to our program. We exclusively assessed professional reimbursement of our patients insured by Centers for Medicare and Medicaid Services (CMS) through the Physician fee schedule website and modeled professional reimbursement of those with private insurance.

Six hundred and seventeen new patients were seen during the study period. One hundred and sixty-six of these were insured through CMS. In evaluation and treatment of these patients, 298 sleep studies were performed on our study cohort. Three hundred and thirty-three patients underwent Drug Induced Sleep Endoscopy (DISE). Two hundred and twenty-eight patients underwent a surgical procedure for the management of their OSA. Four hundred and ninety consultations with other subspecialists were completed. One hundred and sixty-one patients elected not to pursue surgical intervention and were referred to sleep medicine where they returned to CPAP. Using the CMS physician fee website, we found $129,589.77 in professional reimbursements. Financial modeling estimated $901,504.63 in professional reimbursements for those with private insurance.

The establishment of a robust Sleep Surgery program with the ability to offer patients alternative options to CPAP provides significant downstream benefits to both patients and an institution.

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