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The Affordable Care Act and the Future of Sleep Medicine

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Narcolepsy

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Abstract

The Affordable Care Act (ACA), signed into law in 2010, embodies changes in the health-care system that have evolved in response to escalating health-care cost in conjunction with suboptimal outcomes when comparing life expectancy with other western countries. The primary paradigm shift is a change in emphasis away from rewarding performance of medical services to achieving optimal clinical outcomes with the goal of providing care that is cost-effective. Sleep medicine mimics the challenges that have affected the greater system as a whole, as it has been a field that has been driven by polysomnography testing and diagnosis. In responding to the challenges of the health-care system, there has been an increasing emphasis on out-of-center testing for the evaluation of sleep-disordered breathing. However, for sleep medicine to thrive in the future landscape, a much more robust change is necessary. Developing a model of care that provides a concrete infrastructure balancing diagnostic testing with robust follow-up care is necessary. Unfortunately, follow-up care is not only costly, but there is also an insufficient number of sleep specialists to effectively care for the population of sleep disorders. In order to address these challenges, sleep medicine will likely need to embrace team-based care with the use of allied health providers as physician extenders and the use of technology that includes automated care mechanisms that enhance population management, continuous disease management, and self-directed care mechanisms. We also recognize that the identity of sleep medicine needs to expand beyond care of obstructive sleep apnea but into new areas of focus that improve the relevance of sleep medicine for patients and for other medical specialties by collaborating on interdepartmental disease management.

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Author information

Authors and Affiliations

  1. Fontana Sleep Disorders Center, Fontana, CA, USA

    Dennis Hwang MD

  2. Department of Sleep Medicine, Southern California Permanente Medical Group, Kaiser Permanente, Fontana Medical Center, Fontana, CA, USA

    Dennis Hwang MD

  3. Department of Consulting and Implementation, Southern California Permanente Medical Group, Kaiser Permanente, Pasadena, CA, USA

    Burton N. Melius MBA

Authors
  1. Dennis Hwang MD
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  2. Burton N. Melius MBA
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Correspondence to Dennis Hwang MD .

Editor information

Editors and Affiliations

  1. Montefiore Medical Center Narcolepsy Institute, Bronx, New York, USA

    Meeta Goswami

  2. Montefiore Hospital Sleep-Wake Disorders Center, Bronx, New York, USA

    Michael J. Thorpy

  3. Somnogen Canada Inc, President and Chief Executive Officer, Toronto, Ontario, Canada

    S.R. Pandi-Perumal

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Hwang, D., Melius, B.N. (2016). The Affordable Care Act and the Future of Sleep Medicine. In: Goswami, M., Thorpy, M., Pandi-Perumal, S. (eds) Narcolepsy. Springer, Cham. https://doi.org/10.1007/978-3-319-23739-8_31

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  • DOI: https://doi.org/10.1007/978-3-319-23739-8_31

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-23738-1

  • Online ISBN: 978-3-319-23739-8

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