Table of Contents. Introduction...3

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1 A Guide to Choosing the Right Hearing Healthcare Program for Workers Compensation Claimants Eight Critical Benchmarks for Evaluating Potential Partners White Paper

2 Table of Contents Introduction...3 Eight benchmarks for evaluating potential hearing healthcare partners...3 Benchmark #1 - Audiological review for medical necessity...4 Benchmark #2 - Extensive manufacturer and product choices...4 Benchmark #3 - All-inclusive package pricing...4 Benchmark #4 - Comprehensive quality-control processes...5 Benchmark #5 - Rigourous provider and facility credentialing...5 Benchmark #6 - A logical, clearly defined referral process...6 Benchmark #7 - Objective customer satisfaction measures...6 Benchmark #8 - A proactive approach to hearing healthcare...6 Other desirable deliverable and attributes...7 Key takeaways...8 About HearPO...8

3 Introduction An estimated 30 million Americans are exposed to hazardous noise in the workplace, according to the Occupational Safety & Health Administration (OSHA). The Bureau of Labor Statistics reports 2.2 cases per 10,000 workers of significant, permanent hearing loss since 2004, making it one of the most widespread occupational concerns in the United States. The cost to U.S. business is enormous both in terms of workers compensation benefits and diminished productivity for individuals who do not receive treatment for their hearing loss. Compounding these costs, most cases of hearing loss are irreversible and require periodic hearing aid replacement over the lifetime of the affected individual. Hearing loss prevention should be the first priority for companies. And, in fact, noiseinduced hearing loss is highly preventable, especially considering the large and growing array of effective hearing protection solutions available today. Human nature being what it is, however, employees will continue to experience occupational hearing loss, and companies will continue to foot the bill for hearing-related workers compensation claims. This special guide will address the question, How can we minimize the costs, in both the short and long term, for our hearing-related workers compensation claims, while ensuring that employees receive the highest possible level of care and attention to their hearing needs? As this guide will show, these two goals can exist harmoniously. Eight benchmarks for evaluating potential hearing healthcare partners When employees experience a work-related hearing loss, employers have an obligation to and a vested interest in making certain these individuals receive the appropriate treatment and are able to return to their jobs as quickly and productively as possible. Of course, employers must also keep their workers compensation costs under control. The following benchmarks are intended to help individual employers and third-party administrators find a hearing healthcare partner that can help them realize these goals. Eight Critical Benchmarks for Evaluating Potential Partners HearPO 3

4 Benchmark #1 - Audiological review for medical necessity Medical necessity continues to be one of the biggest (if not the biggest) costcontainment issues for workers compensation programs. Specifically, which level of hearing aid technology is the claimant entitled to? And which accessories are necessary? The cost variation from the entry level to the premier level of the hearing aid spectrum can be thousands of dollars per unit, and accessories can bump up the costs even higher. A stringent and consistent audiological review process helps ensure an appropriate level of technology and accessories, balancing the real-world needs of the claimant with the employer s financial constraints. The graph below depicts the percentage of hearing aid fittings by technology level: premier, mid-level and entry-level for a state s self-insurers association, both with and without audiological review. Over a period of four years, the cost savings for this organization added up to nearly $1 million. 80% 70% 60% 50% 40% 30% 20% 10% 0% Source: HearPO Level 3 - High-End No Audiological Review Level 2 - Mid-Level Audiologic Review Benchmark #2 - Extensive manufacturer and product choices Quite simply, the larger the pool of hearing aid manufacturers and product choices, the more providers are available in the market to precisely match a hearing solution to each claimant s needs and avoid costly over-fittings. Private practice audiologists and hearing aid dispensers are often at the mercy of the market to determine the cost of goods for each hearing aid purchased adding unnecessary cost to the worker s compensation employer. Benchmark #3 - All-inclusive package pricing Level 1 - Low-End When evaluating hearing aid prices, the first question should be: What s included in the price? More often than not, bargain pricing translates to a la carte pricing, with a multitude of extra or hidden charges some quite unpredictable adding substantially to the true cost of the hearing aid. For example, Company A includes a one-year warranty with each hearing aid, while Company B s standard warranty is three years. In reality, most hearing aids will not require a factory repair during the first year. However, the need for repairs increases with each passing year and can require hundreds of dollars annually. Therefore, even if Eight Critical Benchmarks for Evaluating Potential Partners HearPO 4

5 Company B s per-unit cost is slightly higher than Company A s, the total cost to a workers compensation program may be substantially lower with Company B. More and more workers compensation programs are gravitating to all-inclusive pricing structures, recognizing the inherent value of the included items, as well as greater predictability for budgeting purposes. Package pricing should include most or all of the following: Benefits package: Popular product options, such as directional microphones, power receivers and telecoil Product warranty for two or three years minimum Loss-and-damage coverage for two or three years minimum Risk-free trial period beyond the typical days Free batteries for two or three years minimum Lastly, program administrators should beware of additional charges in the form of administration or access fees, such as bluetooth technology, cleaning fees or follow-up visits. Benchmark #4 - Comprehensive quality-control processes To ensure an excellent claimant experience, a potential hearing healthcare partner should implement quality-control processes at multiple levels, including: Audiological review (to ensure the most efficacious treatment) Employee training Provider and facility credentialing (see detailed discussion below) Claimant complaint resolution Call center performance, such as average speed of answer, handle time and abandoned calls Benchmark #5 - Rigorous provider and facility credentialing Detailed, rigorous credentialing of hearing healthcare professionals and facilities provides solid evidence of a potential partner s commitment to the highest standards of patient care. Key items in an exhaustive credentialing program include: Equipment requirements and standards Hearing aid fitting protocols before, during and after the fitting Verification of valid state licenses and certifications Professional liability insurance documentation A standardized infection-control plan in place Eight Critical Benchmarks for Evaluating Potential Partners HearPO 5

6 Benchmark #6 - A proven, clearly defined referral process The ability of a hearing healthcare partner to get claimants treatment and back into the workforce as quickly as possible is only as good as its referral processes. Potential partners should have time-tested and clearly defined protocols, from the point an employer or third party makes an employee referral through audiological review, fitting and invoicing. One of the key components of this process is a prompt call (within 24 hours of receiving a referral) to the claimant to schedule an appointment with a hearing healthcare provider. Benchmark #7 - Objective customer satisfaction measures Companies often make glowing claims about the satisfaction of their customers. But what are the customers really saying about their experiences? Independent, customer satisfaction information from independent, unbiased sources carries more weight than company-issued statements about themselves. One of the most respected customer satisfaction metrics is the Net Promoter Score, which measures the degree of loyalty that exists between a company and its customers. NPS scores can range from -100 to +100; any score above 50 is considered excellent and indicates a large number of customers who would recommend the company to others. Benchmark #8 - A proactive approach to hearing healthcare Does the potential hearing healthcare partner s scope extend beyond merely handling workers compensation claims to include education, hearing loss prevention and early intervention? Organizations may demonstrate their leadership and proactive approach to hearing healthcare in a number of important ways, such as: Participating in community health fairs Developing and distributing consumer educational materials Holding open houses that offer free hearing screenings and video ear inspections Educating primary care physicians about hearing loss and hearing aid technologies Offering continuing education opportunities for case managers Offering discounted hearing loss prevention products to employees Offering a non-workers compensation hearing aid discount program to employees Eight Critical Benchmarks for Evaluating Potential Partners HearPO 6

7 Other desirable deliverables and attributes Employers and third-party administrators may want to take their evaluation process to an even higher level, looking for additional desirable deliverables and attributes. For example, does the potential hearing healthcare partner: Produce utilization and cost reports that reveal program efficiency and effectiveness? Offer 24/7 access to a web-based claims system, linked to participating clinics? Conduct ongoing surveys that document the quality of services and products? Offer training by a doctor of audiology and CEUs for claims adjustors? Last, but certainly not least, experience means a lot in the complex world of administering workers compensation claims. Key metrics, such as how long the potential partner has been involved with workers compensation, the number of claims processed annually and the size of the organization s credentialed provider network, can provide an indication of the sustainable success over an extended period of time. Hearing healthcare partner evaluation chart Place a check mark in each box that applies. Benchmarks Partner A Partner B Partner C Audiological review for medical necessity Extensive manufacturer and product choices All-inclusive package pricing Comprehensive quality-control processes Rigorous provider and facility credentialing A logical, clearly defined referral process Objective customer satisfaction measures A proactive approach to hearing healthcare Other deliverables and attributes Partner A Partner B Partner C Utilization and cost reports 24/7 access to a web-based claims system Ongoing service and product quality surveys Claims adjustor training by an audiologist Years of workers compensation experience Number of claims processed annually Eight Critical Benchmarks for Evaluating Potential Partners HearPO 7

8 Key takeaways The ideal hearing healthcare partner can help employers and third-party administrators ensure consistently high-quality care for their workers compensation claimants who have an occupational hearing loss while maintaining good stewardship of their financial resources. The following eight benchmarks should be considered in the evaluation process: A strong, consistent audiological review to ensure medical necessity and the appropriate treatment An extensive array of hearing aid manufacturer and product choices for a precise fit to each claimant s needs All-inclusive package pricing, encompassing product options, warranty, loss-and-damage coverage and other items that otherwise add substantial cost to unit prices Comprehensive quality-control processes, assuring claimants of an excellent experience Rigorous provider and facility credentialing that supports the highest standards of patient care A proven, clearly defined referral process, including 24-hour claimant callbacks to schedule an appointment Customer satisfaction ratings from an independent, unbiased source A proactive approach to hearing healthcare, including an emphasis on education, hearing loss prevention and early intervention Certainly, the evaluation process can involve other criteria, such as utilization and cost reporting, a web-based claim system, ongoing product and service surveys and training for claims adjustors. The organization s expertise, as measured by years of experience, number of claims processed annually and size of its provider network, should also be taken into account. About HearPO HearPO is the largest provider of hearing healthcare benefits in the United States, offering discounted hearing aids and hearing healthcare services as part of an overall benefits package. In addition, HearPO was the first company to administer workers compensation benefits nationally. In business since 1995, HearPO collaborates with individual employers, third-party administrators and durable medical equipment companies to configure workers compensation programs tailored to the client organization and local laws. Key advantages and features of the HearPO workers compensation program include: A rigorous audiological review process to verify medical necessity by a doctor of audiology Access to ten hearing aid manufacturers and hundreds of product options Fixed package pricing that includes hearing aid options, standard threeyear warranty, three-year loss-and-damage protection and more A comprehensive quality-control program, including provider and facility credentialing Eight Critical Benchmarks for Evaluating Potential Partners HearPO 8

9 A nationwide network of more than 3,500 credentialed clinics Callbacks to claimants within 24 hours of referral Ongoing surveys that document the quality of services and products 24/7 access to a web-based claims system, linked to participating clinics Training by a doctor of audiology and CEUs available to claims adjustors Hearing loss prevention programs and products ( A non-workers compensation hearing aid discount program available to all employees HearPO has consistently earned high customer satisfaction ratings, as indicated by a 2013 Net Promoter Score of 72.5 on par with Apple and other companies known for their strong customer loyalty Net Promoter Scores 80% 70% 60% 50% 40% 30% 20% 10% 0% HearPO Apple Google Marriott American Express Resource: Satmetrix 2013 Net Promoter Industry Benchmark report for financial services, technology, online services, retailing, travel, hospitality, insurance and telecommunication industries. HearPO is a division of Amplifon, the largest distributor of hearing aids and hearing services in the world. For additional information or questions, please contact: Amber Lund Director of HearPO and Contracting Ph: Toll-Free: Amber.Lund@amplifon.com Eight Critical Benchmarks for Evaluating Potential Partners HearPO 9

10 5000 Cheshire Parkway North Plymouth, MN HearPO, Corp. 2467CORP