By Neil J. DiSarno
Tomorrow’s audiologists will be diligent practitioners of patient-centered care, more accountable than ever before in requesting reimbursement for services, and regularly pursuing new and different types of professional education.
They will lend their care expertise to resolving acute cases as they always have, but they will also expand to long-term management of patients’ hearing health. And they will be data driven, routinely recording treatment outcomes and patient progress, and at the ready with statistical evidence that validates their care. Failure to pursue approaches like these will put practices at significant risk.
Does that sound like an exaggeration? Think again. Forces of change have been gathering for a while. However, with health care costs at unsustainable levels, change itself is about to bear down. In anticipation of this, last summer audiology organizations co-signed a communication to put their respective members on notice.
Indeed, those who hold the fate of health care practitioners in their hands—lawmakers and policymakers, regulators, health care rating organizations, accrediting bodies, employers, commercial payers, and, last but not least, the public–are insisting on improved care experiences for patients, stressing greater quality and satisfaction. Also, they are demanding improved health for populations generally and measures that promise reduced health care costs.
Neither a policy fad nor an agenda of any one group, such goals are widely accepted. Every indication is that they will be required indefinitely, too, regardless of the results of the U.S. presidential election and the fate of the Affordable Care Act. Practitioners who do not make changes will likely find the road ahead of them pretty bumpy, if not a dead end.
REPORT FROM THE SUMMIT
So what is needed if practitioners are to position themselves to operate viable practices in the future? That question arose for a cross-section of thought leaders, experts, and advocates at “Summit on the Changing Health Care Landscape,” hosted by the American Speech-Language-Hearing Association (ASHA) October 5-7. Summit participants included representatives from all major audiology organizations.
For audiologists and students of audiology, Summit attendees highlighted a number of points, including the following:
- A top priority must be patient-centered care that reflects the patient’s wants, needs, and goals, and that features measures of care value, outcomes, and best practices.
- Audiologists and students will have to be continually educated about a variety of topics in a variety of ways. Subjects should include outcome measures for evaluating intervention steps and demonstrating value of care; reimbursement models; and areas of care such as hair cell regeneration, vestibular prostheses, and cell and gene therapy. Also, inter-professional education should be encouraged; student education should feature models of preferred practice patterns, while online courses about the changing health care landscape and reimbursement issues need to be available to faculty and students alike.
- Data must drive the practice of audiology. Attendees cited the critical need for an extensive and accessible registry of anonymous patient data related to audiological services. By bringing best practices to light, documenting outcomes, and justifying costs, this registry of data would provide a much-needed evidence-based source of defensible arguments to present to reimbursement officials.
These points reverberate in the recommendations from the Summit conference. Ultimately, attendees called for practitioner tools for collecting and mining data related to patients’ auditory and vestibular impairment as well as for providing classification of impairment severity as it affects quality of life. They also recommended an informative model for determining the amount of care an audiologist should deliver.
Other recommendations from the Summit include funding of a multi-centered controlled study to show quality-of-life improvement; developing a means for making hearing aids available to everyone in need of them; and prompting changes in Medicare reimbursement as it pertains to comprehensive care and audiology telepractice.
COURSE OF ACTION TO BE DRAWN UP
The impact of such recommendations remains to be seen. For its part, ASHA has appointed a committee to consider the Summit report and suggest a course of action. Nonetheless, I believe, current and future practitioners of audiology already have encouraging news.
It lies in things such as last summer’s co-signed letter and last month’s Summit, where a wide range of participants addressed the future thoughtfully, realistically, and, above all, proactively. All were keenly aware of their responsibility to play a role in shaping the future of audiology and in equipping their members and constituencies accordingly.
Of course, in the end it will be up to every practitioner of audiology to be in the know, prepared, and adaptive. But for now we all can take comfort that collaboration and pro-action are a proven prescription in cases of uncertainty, especially when strong winds of change are forecast.
Neil J. DiSarno, PhD, CCC-A is Chief Staff Officer for Audiology for the American Speech-Language-Hearing Association, Rockville, MD. For more about the Summit on the Changing Health Care Landscape, see the article on it in the October 30 The ASHA Leader.
