Hearing Health and Technology -- Workshop, Project No. P171200 #00013

Submission Number:
Christopher Spankovich
Initiative Name:
Hearing Health and Technology -- Workshop, Project No. P171200
I applaud the Hearing Health & Technology Workshop for bringing to the light the lack of access to appropriate hearing healthcare. However, my concern is the substantial focus on hearing aids and the unsubstantiated view that hearing aids equal hearing health. Hearing aids are only a component to audiological care and the cost of hearing aids is only a small component in making hearing health care more accessible. Indeed, countries with universal healthcare and access to free hearing aids only have a market penetration of approximately 40%. Removing the requirement of medical approval or wavier may be of greater impact. However, just because over 90% of hearing loss is not medically treatable, does not mean hearing loss is not a medical disorder. Hearing loss is not inevitable and susceptibility can be altered with appropriate hearing health care intervention. Where improved access to hearing health care needs to start is improved access to audiological services. Currently, for an older adult on Medicare to have their hearing testing covered by Medicare requires a referral from a physician and the testing cannot be for the purpose of fitting a hearing aid. Simply removing the requirement for physician referral and forcing an extra step in the process of obtaining appropriately prescription fit devices will improve access without increasing any risk to the patient for the possible 10% of hearing loss that is potentially medically treatable (Zapala et al. 2010). In addition, by enabling direct access to the audiologist without requiring physician approval will save Medicare approximately $240.4 Million over the next 10 years (Dobson et al. 2012). If the true goal of this workshop is to enhance access to hearing health, improving access and covering testing services performed by audiologist including auditory rehabilitation therapy and training, hearing conservation methods, and routing hearing screening, teleaudiology, without requirement for medical referral is the place to start. If you want to lower cost of the device, then force manufactures to sell the device at the same price to point to all consumers including big box and small independent practices. There are great advancements in technology, but consumers will need assistance with getting an appropriate hearing evaluation, devices fit to evidence based prescriptions with with validation and verification of settings, counseling and aural rehabilitation to maximize use and care of the device, repair and maintenance, custom fittings, counseling on secondary prevention, counseling on hearing conservation, etc. My concern here is that making an OTC device without addressing these other and more critical access issues will result in a large group of people trying devices not appropriately fit for their hearing aids and everything sounding loud and tinny and never wearing or waiting another 10 years to see a professional. Unfortunately, this will likely happen as we see it every day in our clinics. Without the appropriate counseling, validation, verification, and therapy hearing aids end up in the dresser drawer more often then not. You can contact me at cspankovich@umc.edu to discuss ways to improve access to hearing health care. I apologize for any typos above.