As a supplement to this info, I found the following article interesting:
Lab Expansion Slows As Home Testing Gains Momentum
Labs offering home testing outnumber those that don't
The key finding of the Q312 Sleep Center Survey, that sleep center expansion has stalled while patient volume growth is increasing, seems to be a paradox. But the seemingly contradictory data can be explained by the dramatic increase in the use of home sleep testing that allows sleep centers to test more patients without adding beds. According to the Q312 Sleep Center Survey conducted by Sleep Review and Mizuho Securities, nearly half of respondents now provide home testing for Medicare patients, while the number providing portable monitoring to privately insured patients has now crossed the 50% mark.
SLEEP CENTERS ADMINISTERING HOME TESTS ARE GROWING RAPIDLY
Currently, 44% of sleep centers offer home sleep testing for Medicare patients (up from 35% in our prior survey), and 51% offer home testing for privately insured patients (up from 41% in our prior survey). Additionally, 64% of the sleep centers expect to be administering home tests in the next 6 months. In two other questions about how the sleep centers were responding to home sleep testing, 45% of respondents have changed their expansion plans as a result of home testing (up from 33% in our prior survey) and 64% of respondents indicated that they expect to increase involvement in home testing (up from 58% in our prior survey). Putting the responses to these questions together, we think that the use of home testing is expanding rapidly at sleep centers.
USE OF AUTO-SETTING FLOW GENERATORS HAS INCREASED
We asked the sleep centers how many of their patients use higher-end flow generators. According to the respondents, 12.6% of patients use auto-setting flow generators, a small increase from 12.0% in our 1Q12 survey. And 10.9% of patients use bi-level flow generators, a small decrease from 11.9% in our 1Q12 survey.
SLEEP CENTER EXPANSION SLOWS
Sleep centers in our survey reported bed growth of 0.8% during the last 12 months and reported an average of 7.6 beds per respondent versus 7.5 beds per respondent 12 months ago. Respondents also expect greater sleep center capacity expansion in the next 12 months (4.6% to 8.0 beds per respondent) than the growth seen in the last 12 months. Compared with our prior survey, both last 12-month and next 12-month bed growth declined to 0.8% from 0.9% and to 4.6% from 7.9%, respectively.
We offer a few caveats about these results. First, we note that sleep center growth covers only part of the entire sleep market, as sleep center growth drives new diagnoses and flow generator sales, while mask sales are mostly driven by replacement sales. Second, sleep center growth as defined in our survey only represents organic growth (beds per center) versus inorganic growth (new sleep centers). Third, as home testing becomes more prevalent, it is possible that sleep center growth may become less correlated with the overall growth in the sleep market. Finally, we note that many respondents are indicating the total number of beds for multiple sleep centers, which pushes the average number of beds per respondent higher (ie, we doubt that the average individual sleep center has 7+ beds). Overall, we think that the survey indicates that patient volume growth remains in the mid-single digits.
PATIENT VOLUME GROWTH IS IMPROVING
On average, respondents have seen patient volume grow 5.9% in the last 12 months and expect 7.0% growth in the next 12 months, and we note that the most common responses were for 0-4% growth in both the last 12 months and the next 12 months. The reported and expected patient volume growth rates are different from the reported and expected bed growth rates (which were 0.8% and 4.6%, respectively). We think that the difference is due to increased use of home sleep testing by the sleep centers, which allows patients to be tested without needing additional beds.
Compared with our prior survey, last 12-month patient volume growth improved to 5.9% from 3.1%, while next 12-month patient volume growth declined slightly to 7.0% from 7.2%.
MORE PATIENTS RECEIVE ORAL APPLIANCES
Medicare now covers oral appliances for patients with sleep apnea. Respondents expect this to increase the number of their patients receiving oral appliances by an average of 2.5% (up from 1.7% in our prior survey) and decrease on the number of their patients receiving CPAPs by 0.1% (down from a 0.1% increase in our prior survey).
ABOUT THE SURVEY
Mizuho Securities USA and Sleep Review magazine conducted a survey of sleep centers. Among the ~12,000 sleep professionals who received the survey, 439 responded to one or more of the survey questions for a response rate of 4%. None of the questions were mandatory, therefore response rates varied from question to question. Of the 439 respondents, 331 (75%) completed the entire survey. The responses were collected between June 16 and July 16, 2012.
We received responses from a range of sleep industry participants with sleep center directors/supervisors/managers (35% of respondents) and registered polysomnographic technicians (28% of respondents) representing the most common titles. Responses also covered every geographic region and all 50 US states with the Midwest (29% of respondents) and Southeast (28% of respondents) being the most heavily represented regions.
fair use applies, from: