Develop a Successful Strategy for Managing Medicare… : The Hearing Journal – LWW Journals
Hearing professionals who want to remain profitable can’t overlook the impact Third Party-Hearing Aid Benefit Programs (HABPs) can have on their business. In today’s market, one in five patients get their hearing aid through a Medicare Advantage plan administered by an HABP, a number that will continue to grow as the baby-boomer generation ages into Medicare eligibility.
www.shutterstock.com. Medicare, Medicare Advantage, Hearing Aid Benefit Programs, HABPs, private-pay…….
Hearing professionals who want to remain profitable can’t overlook the impact Third Party-Hearing Aid Benefit Programs (HABPs) can have on their business. In today’s market, one in five patients get their hearing aid through a Medicare Advantage plan administered by an HABP, a number that will continue to grow as the baby-boomer generation ages into Medicare eligibility.
www.shutterstock.com. Medicare, Medicare Advantage, Hearing Aid Benefit Programs, HABPs, private-pay patient.
www.shutterstock.com. Medicare, Medicare Advantage, Hearing Aid Benefit Programs, HABPs, private-pay patient.
While Medicare Advantage provides patients with access to hearing aids, it deprioritizes the quality of extended clinical services while limiting audiologist flexibility for services and products. The result is that the hearing professional earns substantially less per Medicare Advantage patient when compared with a private-pay patient. In addition, the patient doesn’t reap the substantial benefits of the Continuum of Care model.
However, lower contracted reimbursement rates are not the end of quality service. Hearing professionals can take several steps to continue to offer a high level of service, combat declining revenue due to HABP contracts, find solid financial footing, and thrive in today’s shifting business landscape, all while creating good health outcomes for their patients.
MARKET CHANNELS ARE CHANGING
Just 31% of today’s patients receive their hearing aid via direct pay independent hearing care offices; 26% are fit through retailers, 18% through VA programs, and 22% through Medicare Advantage and Medicaid programs. According to the Kaiser Family Foundation, 42% of current Medicare enrollees have a Medicare Advantage plan, and 72% of the plans have a hearing aid benefit.
In addition, today’s fastest-growing channel is Managed Care. The Independent channel is the fastest shrinking.
THE RISE OF A FALSE NARRATIVE
As hearing devices have become available through channels outside of direct pay to a hearing care professional, a false narrative has arisen around hearing loss treatment. This narrative purports that treating sensorineural/age-related hearing loss involves only getting a hearing test and a hearing aid. That’s because the insurance plans rarely cover other vital services, such as auditory training, ongoing hearing device services, monitoring hearing changes over time, or screening for comorbidities.
With all the emphasis on the product and minimal attention on services, this situation leaves hearing professionals wondering if they’re being forced to abandon the service side, which is critical to patient outcomes, patient satisfaction, and the practice’s success. To answer that question, we need to examine the Value Equation identified in the Service Profit Chain Theory.
