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Insurance Claim for Sleep Apnea in US Increases by 911 Percent

by Shravanthi Vikram on March 7, 2018 at 2:36 PM
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Insurance Claim for Sleep Apnea in US Increases by 911 Percent

According to FAIR health (a national, independent, nonprofit organization), the private insurance claim for sleep apnea has increased by 911 percent in rural America between 2014 and 2017. In contrast the claim is increased only by 839 percent in urban areas. The nation overall insurance claim for sleep apnea was increased by 850 percent. Sleep apnea is a serious disorder in which a person repeatedly stops and starts breathing while asleep.

Rural diagnoses of sleep apnea grew from 0.2 percent of all rural medical claim lines to 1.98 percent. In urban settings, the increase was from 0.13 percent of all urban medical claim lines to 1.24 percent, and in the nation overall, from 0.14 percent of all national medical claim lines to 1.33 percent.


FAIR Health's study was based on data from its database of over 25 billion privately billed healthcare claims, the nation's largest repository of private healthcare claim records. The study is particularly timely in light of the recent finding by the National Transportation Safety Board that engineer fatigue resulting from sleep apnea caused a Long Island Rail Road crash in Brooklyn and a New Jersey Transit train crash in Hoboken, New Jersey, the latter of which killed one person.

Other findings from FAIR Health's study:
  • Males are much more likely than females to be diagnosed with sleep apnea. In the period 2016-2017, males accounted for 65 percent of sleep apnea claim lines, females 35 percent.
  • The age group 51 to 60 years accounted for 31 percent of sleep apnea claim lines--the largest share of eight age groups studied. Patients 61 to 70 years old represented 23 percent of claim lines, while those 41 to 50 years old accounted for 20 percent.
  • In 2017, the states with the most sleep apnea claim lines as a percent of all medical claim lines by state were (ranked from most to least) Maryland, Idaho, Utah, Arkansas and Iowa. The states with the lowest proportion of sleep apnea claim lines were (from least to most) New Hampshire, Minnesota, Massachusetts, Vermont and Hawaii.
  • In 2016-2017, the most common diagnoses associated with sleep apnea on claim lines were diabetes, hypertension, respiratory and chest symptoms, dorsalgia, high cholesterol, general fatigue, joint pain and cardiac dysrhythmias.
  • The three most common (and costly) devices associated with sleep apnea diagnoses were (ranked from most to least): continuous positive airway pressure (CPAP) devices, disposable filters used with positive airway pressure devices and headgear used with positive airway pressure devices.
"Sleep apnea is a public health issue of increasing interest and concern," said FAIR Health President Robin Gelburd. "FAIR Health is ready to contribute its data resources and analytical capabilities to help researchers, policy makers and others address this issue."

Source: Eurekalert

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