Hearing Health and Technology -- Workshop, Project No. P171200 #00078

Submission Number:
Barry Freeman
Initiative Name:
Hearing Health and Technology -- Workshop, Project No. P171200
Patient satisfaction and hearing aid adoption rates have never been higher. It appears that these improved patient outcomes are solely attributed to improved technology. While there have been technological advancements, little attention was paid to the enhancements in professional education of audiologists. In 2008 the accreditation standards for Audiology education changed to require graduates to earn the Doctor of Audiology (Au.D.). The new standards resulted in more didactic coursework and clinical experiences including a one year residency/externship. So, while there certainly have been advancements in technology, there also has been associated enhancements in audiology education. This has resulted in audiologists who are more cognizant of the co-morbidities associated with hearing loss and the relationships between hearing loss and cognitive and cortical reorganization necessitating extensive rehabilitation associated with the fitting of hearing aid devices. Advancements in audiology education and the role that audiologists play in the successful fitting and utilization of these products, through audiology rehabilitation programs, have been the primary reason for improvements in patient outcomes. In markets where there is no formal audiology education, such as Japan, outcomes and patient satisfaction are quite poor despite the adoption of the same hearing aid technology provided to hearing aid consumers in the U.S. In a study of AARP members on the "State of Hearing Health" respondents said "finding a provider with a high level of training on hearing difficulties" was of greatest importance. Also, Taylor and Rogin (2011) found that the number one factor in hearing aid success was the relationship with the provider. Throughout the past decade, representatives from professional associations have met with CMS and legislators to help consumers manage the costs associated with hearing care without success. Freeman and Lichtman (2005) using cy2000 CMS data, demonstrated $168m CMS cost saving by permitting Medicare beneficiaries, direct access to an audiologist. This would have been a 33.6m cost saving to beneficiaries for their co-pay. If there is a change then CMS should be required to permit beneficiaries direct access for audiology services and should cover the rehabilitative services associated with audiology care. This is not a request to cover the cost of a product. It is a request to cover the rehabilitative management and treatment of hearing care services. In that manner, consumers can select their product independent of a professional (e.g., OTC) but the diagnostic, management, and treatment services provided by an audiologist that are necessary for successful patient outcomes would be covered and would not require physician oversight or a referral.