A research team led by the University of Minnesota (U of M) Morris found that a trucking firm that mandated treatment for its drivers with obstructive sleep apnea (OSA) saved significantly on non-OSA-program medical insurance costs.
In new research published in the medical journal Sleep, the U of M Morris-led research team addressed this concern by identifying the savings on the costs of other medical conditions that result from treating OSA.
Researchers analyzed the medical insurance claims of drivers enrolled in the study firm’s sleep apnea screening, diagnosis, and treatment program. To estimate the savings in claims for an individual driver receiving treatment, the research team used a multivariate model to compare the costs of drivers accepting treatment and those refusing it. After excluding claims related to the program itself, they found a savings of $441 per driver per month for the typical driver who accepted treatment.
To estimate the aggregate savings for 100 drivers who were diagnosed and treated, the researchers compared them to 100 “screen-positive” controls (drivers screened as likely to have OSA who had not yet been diagnosed). The cases and screen-positive controls were matched on characteristics (such as job tenure) that affected their likelihood of entering the study. The researchers found a savings of $153,000 for 100 drivers over 18 months. Additional savings came from increased employee retention among treated drivers.
This study found that:
- an employer-mandated program to screen, diagnose, and treat truck drivers for OSA saved the study firm $441 per driver per month in non-OSA-program medical insurance costs;
- the aggregate medical cost savings ($153,000 for 100 drivers over 18 months) were reduced somewhat by driver turnover, but treated drivers were also retained longer. The total savings were sufficient to substantially offset the cost of operating a mandatory OSA program.
“The individual saving of $441 per-driver per-month due to the effective treatment of this disease is very substantial, and deserves attention from everyone who is concerned about high medical insurance costs,” says Steve Burks, PhD, a professor at U of M Morris, in a release. “The aggregate savings for 100 drivers, along with higher retention of treated drivers, were sufficient to offset much of the cost to the study firm of operating an OSA program.”
The statistical analysis was performed at the U of M Morris, where 11 U of M Morris students and 3 faculty members were co-authors. Co-authors at Harvard Medical School and Virginia Tech Transportation Institute also contributed to the work. Both analyses compared costs before and after the OSA diagnosis to control for unmeasured initial differences between groups being analyzed. The full costs of the OSA program itself were not available for the study.
This research was funded by the Region 5 Roadway Safety Institute, the U of M Morris, the study firm, Harvard University, and Virginia Tech Transportation Institute.
Burks is a professor of economics and management and principal investigator of the Truckers & Turnover Project at U of M Morris, and research scholar at the Center for Transportation Studies. Co-investigators of the Truckers & Turnover Project are Jon Anderson, a biostatistics expert and professor of statistics, and Bibhudutta Panda, an applied econometrics expert and associate professor of economics and management at U of M Morris.