“Are we canceled tomorrow night too?” Mor recalled asking. “And she said, ‘Yes.’ I said, ‘How about the next night?’ And she said, ‘Yes.’ I said, ‘So, we’re done?’ And she said, ‘Yes.’ ”
Paul Valentine, chief executive, made the official announcement by conference call. Mor said she is upset about how the closure was handled, with little information provided to employees. She hopes to get a new job as a daytime sleep technologist, but she knows there are many people with similar qualifications looking for work.
Other sleep clinics in Massachusetts have shrunk their overnight capacity and cut staff, citing the change in insurance payments. The Sleep Disorders Center at UMass Memorial Medical Center now operates 10 bedrooms five nights a week, down from 14 rooms filled seven nights a week, said medical director Dr. Stacia Sailer.
Until about four years ago, many insurers would not cover home sleep tests because there was little evidence to show they worked. As the technology changed and research around it grew, insurers in Massachusetts — Fallon Community Health Plan, Tufts Health Plan, and others — embraced it.
Many subcontract with companies that specialize in coverage of sleep testing and provide the equipment necessary to do the home test and treatment. Blue Cross Blue Shield of Massachusetts, the state’s largest health insurer, plans to roll out a a sleep management program later this year to shift testing to the home.
Sailer said the process for getting approval for in-lab tests, when necessary, can be onerous and some companies are slow to mail and process home tests.
Harvard Pilgrim Health Care began using a sleep management contractor in July 2011. About 73 percent of sleep studies now are done in patients’ homes, said Dr. Michael Sherman, chief medical officer. Harvard Pilgrim uses similar specialists to oversee payments for high-cost imaging tests, such as CT scans and magnetic resonance imaging.
Sherman said the federal Affordable Care Act and a state law passed last summer that set health care spending targets put pressure on insurers to control costs.
Epstein, who said he was not notified of the Sleep HealthCenters closure until the day the doors were shut last week, said sleep medicine has hit a turning point. “It’s had a technological disruption, just like a lot of different industries that we see,” he said. “We weren’t nimble enough to adjust in time.”