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J Clin Sleep Med. 2018 May 15;14(5):881-884. doi: 10.5664/jcsm.7130.

Value and Payment in Sleep Medicine.

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Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland.
Sleep Disorders Center, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
Tufts Health Plan, Providence, Rhode Island.


Value, like beauty, exists in the eye of the beholder. This article places the value of clinical sleep medicine services in historical context and presents a vision for the value-based sleep of the future. First, the history of value and payment in sleep medicine is reviewed from the early days of the field, to innovative disruption, to the widespread adoption of home sleep apnea testing. Next, the importance of economic perspective is discussed, with emphasis on cost containment and cost-shifting between payers, employers, providers, and patients. Specific recommendations are made for sleep medicine providers and the field at large to maximize the perceived value of sleep. Finally, alternate payment models and value-based care are presented, with an eye toward the future for clinical service providers as well as integrated health delivery networks.


alternative payment models; health economics; home sleep apnea tests; population health; value-based medicine

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