Volume #2 | February 2019
Audiology Resources
Monthly News & Updates
Happy February! I hope all of you are staying warm and dry wherever you call home!

As you receive this newsletter, I will be in the midst of hosting the 2019 Live Stream Boot Camp! I hope that some of you have registered to attend! I have made significant changes for this years event and, unbelievably, have added another 50+ slides! Soon my infamous booklet will be too big to print!

My next boot camp, after the Live Stream, will be April 25 and 26th in Newark, New Jersey! I hope some of you choose to join us! The 2019 format for the face to face events will include more opportunities for small workgroups and attendee engagement. I have also added some new, disruptive ideas and discussion points!

I hope all of you are enjoying the newsletters and the information being shared! Please let me know if you have any feedback, positive or negative, as I want to make this something useful for audiologists and their staff.



Monthly Coding and Reimbursement Tips
United Healthcare, BCBS, Aetna, and Cigna, as well as Medicare (through local coverage determinations) and state Medicaid programs, have medical policies specific to the coverage audiology diagnostic and rehabilitative services, hearing aids, and auditory prosthetic devices. These policies are located on payer websites and in payer provider portals.

United HealthCare, for example, has a national policy on hearing aid coverage for their Commercial insurance products. You can view this policy at UHC Hearing Aid Policy .

Standard, commercial UHC plans include coverage for wearable, air-conduction hearing aids that are purchased as a result of a written recommendation by a physician.

Benefits are provided for the hearing aid and for charges for the associated fitting and testing. The wearable, air conduction hearing aid benefit does not include batteries, accessories, or dispensing fees.

If more than one type of hearing aid can meet the member’s functional needs, benefits are available only for the hearing aid that meets the minimum specifications for the member’s needs. If the member opts for and purchases a hearing aid that exceeds these minimum specifications, UnitedHealthcare will pay only the amount that it would have paid for the hearing aid that meets the minimum specifications, and the member will be responsible for paying any difference in cost.  In other words, the patient now be responsible for upgrade costs.

Topics like these are addressed, in detail, in the 2019 Boot Camp events.

Research Spotlight

I am passionate about improving the access to hearing and balance care. You may also know that I am part of the extended Northwestern University family (I am an adjunct lecturer).

As a result, I have been fascinated by CEDRA and PEDRA, since I was first introduced to it by Sumit Dhar, PhD and David Zapala, PhD in 2015. These tools can be invaluable in disease detection prior to hearing aid use and should be evaluated for use across out profession. They have been found to be quite sensitive to otologic conditions.

You can learn more at CEDRA and the Disease Detection Tool.

Owning the Audiology Space
Accessibility is the Answer
Consumers turning to telemedicine, over the counter healthcare options and self-assessment tools, in audiology and throughout healthcare. Why? Affordability is one reason but an even more prevalent reason is access. The data surrounding accessibility is compelling. Data from the Consumer Healthcare Products Association ( https://www.chpa.org/marketstats.aspx ) indicates that consumers make approximately 26 trips a year to purchase over the counter healthcare products but only three trips to their physicians. Also, 60 million Americans would not seek treatment for their illnesses without over the counter options. Why would visits to an audiologist be any different? Maybe these statistics help explain the hearing aid adoption dilemma.

There are 328 million Americans today ( https://www.census.gov/popclock/ ) and approximately 15000 audiologists ( https://www.bls.gov/oes/2017/may/oes291181.htm ). This calculates to one audiologist per every approximately 22,000 Americans. Let’s take this further and consider the state of North Dakota. North Dakota is 70,000 square miles and has 50 total audiologists. This is one audiologist every 1400 square miles. This is limited access.

Let’s think about the typical process to merely get an individual’s hearing tested. Most audiology clinics are open Monday through Friday, from 8AM to 5PM, with an hour off for lunch. A consumer would need, in most cases, to take three hours off of work to visit your clinic. It could take 30-45 minutes to drive to your office and park. We also expect patients to arrive 15 minutes early to complete intake paperwork. The patient may spend 30-60 minutes in the evaluation. Then, they reverse their commute and head back to work. The problem is that  every individual does not have access to paid sick leave or paid time off ( https://www.bls.gov/news.release/pdf/ebs2.pdf ) or have the ability to be seen on OUR schedule. This is one of the reasons why we have seen a rise in urgent care clinics ( https://www.medicaleconomics.com/business/whats-behind-growth-urgent-care-clinics ). Consumers want and need ease, convenience and accessibility.

Now, let’s say the individual needs a hearing aid. This three-hour commitment expands to an additional six to ten-hour commitment for evaluation, fitting and orientation, and follow-up visits within the first 30-60 days. This can mean more time away from work, for the patient, their communication partner, their caregiver, their adult child, their transportation individual, etc. than anyone can afford. People do not want to take off without pay or use their precious paid time off to work within this 8-5 schedule. So, instead, the individual does not prioritize the hearing loss because of the lack of convenience and accessibility to solve the issue through traditional delivery channels or they turn to disruptive options, such as self-assessment, counter or direct to consumer products and services. 

In order to compete with over the counter or direct to consumer competition, we are going to have to change the way we function. We are already seeing this evolution in many other healthcare arenas, including primary care, dentistry, optometry and chiropractic care. Evening and weekend hours are the norm. My optometrist, for example, opens later (10 -11AM) and closes later (7PM) and is open a full-day on Saturday.

What are audiologists willing to do to meet consumers desires and needs? How long will the “we are doing it my way” approach be able to sustain itself? We have to be willing to meet the needs of today’s consumers or they will turn to other disruptive entities who will happily fill the void. The 8-5 world is now a 24/7 world. Here are some things to consider:

·       Concierge care (available to the individual at a higher cost) where you go to the individual.
·       Walk-in or call in times every day.
·       Telepractice.
·       Flexible appointment times outside the 8 AM to 5 PM window and on weekends (by appointment only).

We cannot complain about industry disruptions if we fail to respond to consumer’s needs for accessibility and convenience. Now is the time to discard our 1960s delivery model in favor of a 21 st century model.