COSTS IN HEARING HEALTHCARE

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Eustace Heath
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1 COSTS IN HEARING HEALTHCARE Gail Linn, Au.D. Potomac Audiology Rockville, MD

2 THE AUDIOLOGIST AND HEARING AID DISPENSER

3 What is involved in dispensing a hearing aid? 1. Hearing Test to Determine Needs (1 hour) 2. Hearing Aid Evaluation (1 hour) 3. Fitting the Hearing Aid(s) (1 ½ hours) 4. Follow-up Visits (6 to 12 hours)

4 Hearing Aid Evaluation 1. Determine which hearing aid style works best for the hearing loss. 2. Determine which hearing aid style works best for the patient in terms of personal preferences, visual and cognitive capabilities as well as dexterity. 3. Costs

5 Fitting the Hearing Aids 1. Fitting the Hearing Aid with Probe Microphone Measures 2. Teaching the patient how to use and handle the aids.

6 Probe microphone measures

7 Probe microphone measures First Fit

10 First Fit After Fine Tuning Adjustments

11 Teaching the patient how to handle the aids 1. How to put the aid in the ear 2. How to turn the aid on and off 3. How to change the battery 4. How to clean the aid

12 Follow-up visits 1. I bring my patients back once a week until we have the hearing aid(s) working properly: 4 to 6 visits 2. Then a one month visit 3. Then every three months 4. At the one year mark we repeat the hearing test and perform real ear measures

13 How much time is spent in the first year? 10 to 15 hours

14 What is our markup? I mark-up our hearing aids $ above our cost. (Range of mark-up: $ to $ per aid; depends on many factors) Approximately $ goes to overhead The remaining $ goes to professional fees

15 Hearing Aid Prices Basic Hearing Aid - $ Mid-Level Hearing Aid - $ Premium Level Hearing Aid - $ (There really is a difference in the technology and flexibility at each level.)

16 Unbundling pricing (Itemization) Cost of hearing aid might be invoice price plus $ Fitting fee might be between $ and $ per aid Follow-up visits might be $50.00 for 30 minute appointment and $ for a one hour appointment.

17 New patients often come with hearing aids they have already purchased

18 Personal Sound Amplification Products (PSAPS) have come to the office

19 The Bean (EtymÖtic Research, Inc.)

20 THE MANUFACTURER

21 Price of hearing aids from the manufacturers Research and development The manufacturers allow individuals to try hearing aids, even custom aids, and will allow them to return the aids for a full refund The manufacturers give warranties from 1 to 5 years for both breakdown and loss and damage Actual prices the manufacturers charge to dispensers is approximately $ to $ per aid

22 QUESTIONS THAT MANY PEOPLE ARE ASKING ABOUT HOW TO MAKE HEARING AIDS MORE AFFORDABLE

23 What about patients who cannot afford hearing aids? Our office participates with the Starkey Hear Now Program Patients donate hearing aids to be given to those who cannot afford new hearing aids We allow people to pay over a 6 month period without interest We sell pre-owned hearing aids at a reduced price

24 What about over the counter Hearing Aids? Hearing aid fitting is more complex than just inserting an aid or magnifier in the ear; if the hearing aid does not match the prescription the patient is not going to do well Counselling is an important component of the success of a hearing aid fitting; without it most patients would become frustrated and give up Maintenance is also an important part of the ongoing care of a hearing aid

25 What do I think of the FDA medical clearance requirement? I personally do not think it needs to be required anymore. Audiologists have been trained to know when to refer to a medical professional. I have a great relationship with many Otolaryngologists and Internists, and other healthcare providers in our community. It adds costs for Medicare and the insurance companies; recent research supports the safety and efficacy of audiologists as entry-level into the healthcare of the patient (for hearing loss)

26 POSSIBLE SOLUTIONS

27 How can we help more people afford hearing aids? Audiologists do not have to do all the training and counselling, that could be done by audiologist assistants which could lower the cost; this model exists in the VA and the DoD and in the private sector Audiologists can dispense PSAPS and measure them to make sure they are matching target or at least close enough to be beneficial Most of the large hearing aid manufacturers are working on PSAPS which would improve options and offer more features for better fittings

28 How can we resolve some of these issues? Insurance companies could pay for a portion of the hearing aids and allow the Audiologist to balance bill if the patient s hearing loss requires a better hearing aid; BCBS Federal does this and it is very successful Hearing aid companies could offer some products with shorter warranty periods which would drive down the cost Dispensing offices could offer bundled and unbundled pricing

29 Final thoughts Hearing wellness and healthy aging starts with the recognition that untreated hearing loss is indeed a public health threat All the data, empirical and anecdotal, supports the need for increased access to care Hearing care costs something; someone has to pay for it (just like all other necessary healthcare) Not all patients need the same level of ongoing care but all patients need a quality, initial level of care and many need ongoing monitoring to be successful

30 THANK YOU

Purchasing Hearing Aids What You Need to Know

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