I have had several physicians email/call/PM me recently about how to start a sleep lab, and whether it is still possible with the new CMS decision on home testing.
Regarding home testing: this will have a negative financial impact on sleep physicians, but I don't think it precludes a physician from starting a sleep lab. A lot is still up in the air, however, and the full financial implications of home testing are uncertain.
Even before the CMS decision, starting a sleep lab was a difficult process. I would encourage any physician (or technician or business person) who is interested in starting a sleep lab to attend the annual February American Academy of Sleep Medicine Management Course (see the AASM website for details).
Some things for a physician to think about in starting a sleep lab:
1. Where are the patients going to come from? If you are a pulomonologist and part of a pulmonary group, your group can probably generate enough sleep patients to sustain a sleep lab (roughly 1 sleep bed/pulmonologist). If you are a solo psychiatrist or neurologist, things are going to be tough.
2. Are you established in an area? It's easier to start a sleep lab if you are already a practicing physician in an area and a member of insurance networks.
3. Do you have a million dollars sitting around? The start-up costs for a 6 bed sleep lab are $500,000 to 1 million.
4. Who's going to manage the lab (hire/train technicians, get the lab in network/accredited, etc)? There are companies that you can work with in this regard. There are several companies that both own sleep labs and that partner with physicians and hospitals to run sleep labs- United Sleep Medicine, SleepWorks.
5. Don't even think about becoming involved in DME if you are an inexperienced physician just coming out of sleep fellowship. If you do eventually get involved in DME, make sure the situation is reviewed by a lawyer who is knowledgeable about Stark/anti-kickback rules.
More later.
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8 comments:
Thanks Dr Rack,
Great comment.
Vinod
What type of bed would you say is the best for a sleep lab? What type do you use? Great information, thanks!
where can I find a document which states that a physician can own no more than 40% of a sleep clinic in which he/she is self referring sleep study patients?
Hey Doc, i know its always good to have extra investment in business but, dont you think 500,000 to a million is a bit too much... if you lease the equipmnt shudnt 100,000 be more than enough?
was wondering if a doctor could significantly cut sleep center startup costs by using an existing physician's office and/or AAAHS surgery center. Would this suffice?
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