More on Sleep Apnea

[Buck52]

Opportunities Missed to Contain Spending on Sleep Apnea Devices and Improve Veterans’ Outcomes

Veterans Affairs Office of Inspector General (OIG) sent this bulletin at 01/14/2020 12:34 PM EST

Opportunities Missed to Contain Spending on Sleep Apnea Devices and Improve Veterans’ Outcomes

01/13/2020 07:00 PM EST

 

The VA Office of Inspector General (OIG) conducted this audit to determine if the Veterans Health Administration (VHA) is efficiently managing positive airway pressure devices (sleep apnea devices) and supplies for veterans diagnosed with sleep apnea. The number of veterans diagnosed with sleep apnea who receive devices and supplies increased dramatically between fiscal years 2014 and 2018.

This has significantly increased the financial risk to VA. If VHA does not change its practices and leverage opportunities to save money, the OIG estimates it risks spending about $261.3 million over the next five years on devices and supplies veterans will not use. VHA did not efficiently manage sleep apnea devices and associated supplies. The OIG found that almost half of the 250,000 veterans issued a device from October 2016 through May 2018 used it less than half the time. This can reduce therapy effectiveness.

The mismanagement occurred in part because VHA did not identify and follow up with veterans who were not using their devices as recommended. The OIG also found that VHA did not have a sleep medicine staffing model to help ensure it conducted patient follow up. A model will determine staffing to help ensure follow up is conducted. VHA could save up to $39.9 million per year by loaning devices to veterans rather than issuing them for permanent use. A loan program would allow unused devices to be returned and reused. VHA could save up to an additional $12.4 million per year by not purchasing device supplies for veterans who do not use their devices. The OIG made three recommendations to the under secretary for health regarding sleep apnea device management. The recommendations include studying staffing levels, looking at using existing technologies to better monitor device use, and looking at alternatives to purchasing devices.

[Vync]

Loaners, eh? That worries me because of all the gear the military loaned me while in the service which had issues and problems. Imagine getting your loaner CPAP machine and it craps out after a couple of days because it's previous user did a shoddy job taking care of it.

These thing are not built sturdy, like portable oxygen generators.

[GBArmy]

I'm not sure I like the idea of a loaner either. I can see a unit being returned, not inspected and cleaned up, and just put on the shelf to be shipped out to some other veteran. And speaking about clean, that doesn't sound too great either. Gotta be germs just sitting  there waiting to get into you. And, unless you live close enough to hand carry it to the VAHC for an immediate replacement, it's gotta take several days to ship it back and get another one in the return mail. That's several days of unhealthy sleeping.Na, I don't think I like the idea.

[Dustoff1970]

They need better adjustable fitting mask and offer veteran option of a longer hose instead of him finding out about this after the fact from other vets.  Last visit they said there was no need for me to even bring the machine with me as they can tell from there read outs if it is being used.  I have had trouble with two of their mask and may buy one for a better fit if I can find it.  As in many cases the VA never volunteers any additional info that might help the vet.  He has to learn a lot from other vets.

Edited January 14, 2020 by Dustoff 11

[GBArmy]

Dustoff 11 Last September I got 2 replacement masks after getting a hard time from them; seems usage is supposed to be minimum of 2 months per mask. I told the tech that the rubber wouldn't hold up and would tare after only 3 or 4  weeks. I used to use masking tape to patch them up so they wouldn't leak.This last 2 replacement masks are GREAT! They must have changed suppliers or something. As it so happens, I ordered and just receive some new equipment; new mask, harness and hose. And you are right about them collecting the data; they get it every morning digitally. We don't have to bring it in unless it is a repair situation. I just hope the material used for the mask is the same as my last ones.

[Vync]

1 hour ago, Dustoff 11 said:

They need better adjustable fitting mask and offer veteran option of a longer hose instead of him finding out about this after the fact from other vets.  Last visit they said there was no need for me to even bring the machine with me as they can tell from there read outs if it is being used.  I have had trouble with two of their mask and may buy one for a better fit if I can find it.  As in many cases the VA never volunteers any additional info that might help the vet.  He has to learn a lot from other vets.

You are so correct. There were some nights when I awaken to find out that I rolled over and pulled the machine off the table beside my bed.

[Vync]

1 hour ago, GBArmy said:

Dustoff 11 Last September I got 2 replacement masks after getting a hard time from them; seems usage is supposed to be minimum of 2 months per mask. I told the tech that the rubber wouldn't hold up and would tare after only 3 or 4  weeks. I used to use masking tape to patch them up so they wouldn't leak.This last 2 replacement masks are GREAT! They must have changed suppliers or something. As it so happens, I ordered and just receive some new equipment; new mask, harness and hose. And you are right about them collecting the data; they get it every morning digitally. We don't have to bring it in unless it is a repair situation. I just hope the material used for the mask is the same as my last ones.

They give me some cheap ResMed supplies. The stuff is utter crap. It works fine for about a month (aside from not fitting perfectly), but then the seals start going. Nothing like wearing a nasal pillow and having the seal joint leak and blow air all over you. Rotating the hose joint can sort of help, but after another month forget it. I just started sending them secure messages to let them know that the garbage they send me has began leaking again. And then the VA boasts online about having top quality medical care, but they don't let people know they use substandard medical supplies.