Several sources estimate Medicare will be insolvent by 2028. This dire prediction has produced numerous suggestions regarding how to cut medical costs and maintain Medicare.
In the area of hearing healthcare this charge for Medicare cost efficiency is led by otolaryngologist Frank Lin of Johns Hopkins Medical University.
Dr. Lin has suggested hearing healthcare could be more affordable by first removing all medical oversight for adults with mild-to-moderate hearing loss allowing them to self-diagnose and self-treat their hearing losses.
Lin’s second strategy involves making low-cost, over-the-counter (OTC) hearing aids available without medical interference.
Not surprisingly the American Academy of Otolaryngology, The American Speech-Language-Hearing Association and the American Academy of Audiology cautioned against such measures.
Undeterred Dr. Lin and a panel convened by the National Academies of Science, Engineering and Medicine (NAS), who largely determine Medicare expenditures, produced 14 recommendations for improving hearing healthcare including Lin’s call for self-treatment and self-diagnosis of hearing loss and provision of OTC hearing aids.
So influential were these recommendations the Food and Drug Administration immediately announced it would no longer require medical oversight prior to obtaining hearing aids and would consider creating a class of OTC hearing aids.
Because no scientific evidence supports these recommendations NAS recommended that the National Institutes of Health (NIH) provide grant money to help obtain such proof.
Recently audiologist Larry Humes and colleagues at Indiana University published an NIH-funded article in the American Journal of Audiology that allegedly provided such proof.
A lay person might assume for this study Dr. Humes recruited adult subjects with mild to moderate hearing losses, let them select OTC hearing aids such as those at Amazon and compared their performance to state-of-the-art hearing aids with full audiology services.
Such was not the case. Humes gave state-of-the-art hearing aids to people with minimal hearing loss and provided comprehensive hearing, medical and psychological evaluations to all. He programmed state-of-the-art hearing aids for these subjects based on three theoretical hearing losses. Subjects were instructed on hearing aid assembly and use.
Even though no OTC hearing aids were used in this study the NIH website immediately announced ” Model approach for over-the-counter hearing aids suggest benefits similar to full-service purchase.”
Pointing to the evidence supplied by Humes Medicare may now argue recipients can afford OTC hearing aids independent of medical/audiological oversight.
The Humes study offers Medicare two cost saving measures. First, discussion of Medicare hearing aid payment can be tabled, and the current practice of Medicare payment for audiological evaluation under specific circumstances can be discontinued as such services allegedly provide little benefit to the patient.
Based on Humes’ evidence we expect Medicare will stop paying for hearing evaluation in the near future.
At the July 13th meeting of the Oregon Association for Better Hearing at Good Samaritan Hospital Corvallis we present evidence that questions the Humes’ study findings. Meeting time 3:30 to 5pm. Public is welcome; no charge.
For more information contact Dr. Leavitt (541) 754-1377.