We will undoubtedly see many innovative changes in how hearing aids and personal sound amplification products (PSAPs) are manufactured and distributed in the coming decades.
So wrote Dennis Van Vliet on October 24, 2011, soon after hiHealthInnovations announced plans to provide hearing aids directly to consumers rather than through licensed practitioners. The news generated much discussion and debate in the hearing care arena and prompted a series of posts in the Hearing Health section of HHTM designed to provide readers with a variety of informed perspectives on this issue. Dr. Van Vliet’s post framed the ensuing debate and did a good job of forecasting the present situation as we enter 2017.
Eliminating the professional’s role from dispensing is called “unfair to consumers”
By Dennis Van Vliet
Dennis Van Vliet, AuD
Last week on Hearing Views, Lisa Tseng, CEO of hi HealthInnovations, discussed the underutilization of hearing aids among potential candidates. She asserted that high cost is a “significant contributor” to the problem, and that United Health Group, parent company of hi HealthInnovations, saw an opportunity to introduce a solution to the cost barrier with its direct-to-consumer sales of open-fit hearing aids.
There is general agreement in the industry that many individuals who need hearing aids do not own them. But is the “high cost” of hearing aids a significant factor in creating this situation?
We know from data in the global market that there isn’t much difference in the rate of acquisition of hearing aids between the US and Europe, where many countries provide hearing aids at little or no cost. Australia, with its generous national benefit and comprehensive consumer education program, has the highest rate of hearing aid acquisition, but it is still less than 40%.
It is probably true that cost is one factor, though it is unclear how great a role it plays in the complex question of why hearing aids are so underutilized by people with hearing loss.
Given that most patients are not tested for hearing loss during a routine physical examination and that only 14% of patients reported that their primary-care physician even inquired about hearing loss (Kochkin 2002), offering simple screening methods to allow patients to learn more about their hearing status on their own can be viewed as a good thing for consumers.
hi Health Innovations is to be commended for its development of an at-home hearing test that can increase consumer awareness and possibly prompt positive action by people whose hearing loss has previously gone untreated. New computer, hand-held device, and tablet computer capabilities are such that monitoring ambient noise, and overcoming large calibration errors with headphones is possible.
BYPASSING THE PROFESSIONAL OFFERS SMALL SAVINGS
However, taking the leap to providing hearing aids without the direct involvement of a qualified professional is another question. According to MEDCity News, the UnitedHealth Group hearing aids will be offered at $749 to $949 per ear.
Paying $1500 to $2000 out of pocket for a pair of hearing aids without a fitting or even a simple look in the ear to rule out wax or foreign objects doesn’t seem like much of a cost savings. Since most hearing aid manufacturers and retailers offer a wide range of hearing aids, from economy models to highly featured products, it probably wouldn’t take more than a phone call or two in most communities to find a qualified provider who would match or beat the United Health Group retail fees. Plus the practitioner would throw in a look in the ear at no additional cost!
The roles of audiologists and hearing instrument specialists evolved because typical patients need expert assistance in determining their candidacy for hearing aids, fitting them properly, counseling on appropriate use and care of the instruments, and rehabilitative strategies. While not all patients need all of the services offered, they do need guidance beyond an instruction booklet and an online video.
We will undoubtedly see many innovative changes in how hearing aids and personal sound amplification products (PSAPs) are manufactured and distributed in the coming decades. We can look forward to improvements that may very well reduce cost, as well as enhance the availability and effectiveness of these products.
But taking existing technology, eliminating needed service, and calling the result a discounted offering is grossly misleading and unfair to consumers, is not in their best interests, and is certainly not an improvement over the existing distribution model.
Unless the motive is purely to increase its profits, United Health Care should look again at its effort to “…open the door to a new, hearing-enabled life for the millions who could benefit from it but, for a variety of reasons, don’t.”
Reference
Kochkin S: MarkeTrak VI: 10-year customer satisfaction trends in the US hearing instrument market. Hear Rev 2002;9:14-46.
Dennis Van Vliet, AuD, an audiologist with 36 years of experience, has provided clinical services in medical, educational, and private-practice settings. His professional interests have focused on hearing aids, and his opinions are frequently solicited for US and international publications and lectures. Dr. Van Vliet earned his master’s in speech communication from California State University and his AuD from Central Michigan University. For years, he has expressed his opinions in the Final Word feature, first at The Hearing Journal and more recently at Hearing Review. Dr. Van Vliet is Senior Director of Professional Relations for Starkey Labs. All views expressed in this post are those of Dr. Van Vliet.
I strongly agree with this paragraph of this article! Both as a consumer advocate and having members of my family who wear hearing instruments. I know from my own experiences with consumers, family and friends that have hearing loss!
What good is an instrument or tool of any kind if…it doesn’t fit your needs, you don’t know how to use it or care for it properly and it just sits there collecting dust or in a drawer? Think about it!!!
“The roles of audiologists and hearing instrument specialists evolved because typical patients need expert assistance in determining their candidacy for hearing aids, fitting them properly, counseling on appropriate use and care of the instruments, and rehabilitative strategies. While not all patients need all of the services offered, they do need guidance beyond an instruction booklet and an online video.”
It would be naive to believe that the United Health Group and HealthInnovation have constructed this business model to increase market penetration for hearing instruments. (Thank you, Dennis for the stats). This model is purely driven by a profit motive at the detriment of even basic quality standards that consumers of health care should receive.
What is the future of our profession? How can we protect what we’ve worked so hard to achieve?
I must remind myself that success is “2% inspiration and 98% perspiration”. Health Innovation will have a lot of sweating to do to undermine the strength of our profession!
The cost of hearing aids most certainly is the chief factor in why hearing impaired individuals go without them. One of the reasons we don’t have national health coverage is all of the vested interests of private practitioners and insurance companies.