The AASM Payer Policy Review Committee (PPRC) launched an initiative to assess the alignment between clinical practice guidelines (CPGs) and private payer medical policies. This article summarizes the importance of the initiative, details the scorecard development process, including an analysis of policy scores and subsequent revisions, and discusses the impact of the scorecards particularly as related to the scorecards on the CPG for diagnosis of obstructive sleep apnea (OSA) in adults. This initiative has increased communication and engagement amongst members of the PPRC and private payers, creating opportunities to advocate on behalf of sleep medicine providers and patients with sleep disorders, encouraging payers to modify existing policies so that evidence-based care is provided to patients with sleep disorders.
Article
Addressing Gaps Between Payer Policies and AASM Clinical Practice Guidelines Using Scorecards
All Scholarly Works
Document Type
Article, Peer-reviewed
Publication Date
2-1-2020
Disciplines
Abstract
PMID
32108569
Citation Information
Kaplish N, D'Andrea L, Auger RR, Gay P, Jacobowitz O, Johnson K, Lance C, Licis A, Patil S, Summers M, Vohra KP, Abbasi-Feinberg F. Addressing Gaps Between Payer Policies and AASM Clinical Practice Guidelines Using Scorecards. J Clin Sleep Med. 2020 Feb 28.