Cost-Benefit Analysis of Hearing Care Services: What Is It Worth to Medicare?

Amber Willink; Nicholas S. Reed; Frank R. Lin

doi:10.1111/jgs.15757

Cost-Benefit Analysis of Hearing Care Services: What Is It Worth to Medicare?

Amber Willink, Nicholas S. Reed, Frank R. Lin

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Objective: Hearing care services for older adults with hearing aids are underutilized and are not covered by the Medicare program. Little information exists to the value of hearing care services for older adults with hearing aids. The objective of this analysis is to estimate the potential costs and benefits to the Medicare program of covering hearing care services. Design: Cross-sectional analysis using propensity score matching methods to create balanced and comparable groups. We conducted a 1:1 match of older Medicare beneficiaries with hearing aids who self-reported use of hearing care services in the previous 12 months to those with hearing aids who did not use hearing care services. Groups were balanced on demographic and socioeconomic characteristics as well as health status, functional impairment, and trouble hearing. We compared average total Medicare spending per person between matched groups, as well as by service type. Setting: Nationally representative survey of Medicare beneficiaries in the United States (Medicare Current Beneficiary Survey) 2013. Participants: Study participants were limited to those in the survey who reported using hearing aids in 2013 (n = 1120). Results: Average annual Medicare spending was $8196 (95% confidence interval [CI] = $6670-$9723) among Medicare beneficiaries who used hearing care services and $10,709 (95% CI = $8878-$12,541) among matched controls who did not use hearing care services. Total spending per person was $2513 (95% CI = $150-$4876) higher among those who did not use hearing care services, with spending differences driven mostly by higher-skilled nursing facility (difference = $825; 95% CI = $193-$1455) and home health (difference = $287; 95% CI = $7-$568) spending among matched controls. Conclusion: Utilization of hearing care services among older adults with hearing aids is associated with reduced Medicare spending. Increasing access to hearing care services among Medicare beneficiaries with hearing aids may provide value to the healthcare system and net savings to the Medicare program. J Am Geriatr Soc 67:784–789, 2019.

Original language	English (US)
Pages (from-to)	784-789
Number of pages	6
Journal	Journal of the American Geriatrics Society
Volume	67
Issue number	4
DOIs	https://doi.org/10.1111/jgs.15757
State	Published - Apr 2019

Keywords

Medicare
cost-benefit analysis
hearing loss

ASJC Scopus subject areas

Geriatrics and Gerontology

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10.1111/jgs.15757

Cite this

@article{f3bf5e54a464414eba472f7923b5821a,

title = "Cost-Benefit Analysis of Hearing Care Services: What Is It Worth to Medicare?",

abstract = "Objective: Hearing care services for older adults with hearing aids are underutilized and are not covered by the Medicare program. Little information exists to the value of hearing care services for older adults with hearing aids. The objective of this analysis is to estimate the potential costs and benefits to the Medicare program of covering hearing care services. Design: Cross-sectional analysis using propensity score matching methods to create balanced and comparable groups. We conducted a 1:1 match of older Medicare beneficiaries with hearing aids who self-reported use of hearing care services in the previous 12 months to those with hearing aids who did not use hearing care services. Groups were balanced on demographic and socioeconomic characteristics as well as health status, functional impairment, and trouble hearing. We compared average total Medicare spending per person between matched groups, as well as by service type. Setting: Nationally representative survey of Medicare beneficiaries in the United States (Medicare Current Beneficiary Survey) 2013. Participants: Study participants were limited to those in the survey who reported using hearing aids in 2013 (n = 1120). Results: Average annual Medicare spending was $8196 (95% confidence interval [CI] = $6670-$9723) among Medicare beneficiaries who used hearing care services and $10,709 (95% CI = $8878-$12,541) among matched controls who did not use hearing care services. Total spending per person was $2513 (95% CI = $150-$4876) higher among those who did not use hearing care services, with spending differences driven mostly by higher-skilled nursing facility (difference = $825; 95% CI = $193-$1455) and home health (difference = $287; 95% CI = $7-$568) spending among matched controls. Conclusion: Utilization of hearing care services among older adults with hearing aids is associated with reduced Medicare spending. Increasing access to hearing care services among Medicare beneficiaries with hearing aids may provide value to the healthcare system and net savings to the Medicare program. J Am Geriatr Soc 67:784–789, 2019.",

keywords = "Medicare, cost-benefit analysis, hearing loss",

author = "Amber Willink and Reed, {Nicholas S.} and Lin, {Frank R.}",

note = "Funding Information: Financial Disclosure: This study was funded in part by the Commonwealth Fund (grant 20171061) and the Cochlear Center for Hearing and Public Health at Johns Hopkins University School of Public Health. Conflicts of Interest: N.R. is on the Scientific Advisory Board for Clearwater Clinical. F.L. has served as a consultant to Boehringer Ingelheim, Amplifon, and Cochlear Ltd. Author Contributions: A.W. crafted the study concept and design and was responsible for acquiring the data and conducting the analysis. A.W., N.R., and F.L. all contributed to the interpretation of the data and preparation of the manuscript. Sponsor's Role: The Commonwealth Fund and the Cochlear Center for Hearing and Public Health had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Funding Information: Financial Disclosure: This study was funded in part by the Commonwealth Fund (grant 20171061) and the Cochlear Center for Hearing and Public Health at Johns Hopkins University School of Public Health. Publisher Copyright: {\textcopyright} 2019 The American Geriatrics Society",

year = "2019",

month = apr,

doi = "10.1111/jgs.15757",

language = "English (US)",

volume = "67",

pages = "784--789",

journal = "Journal of the American Geriatrics Society",

issn = "0002-8614",

publisher = "Wiley-Blackwell",

number = "4",

}

TY - JOUR

T1 - Cost-Benefit Analysis of Hearing Care Services

T2 - What Is It Worth to Medicare?

AU - Willink, Amber

AU - Reed, Nicholas S.

AU - Lin, Frank R.

N1 - Funding Information: Financial Disclosure: This study was funded in part by the Commonwealth Fund (grant 20171061) and the Cochlear Center for Hearing and Public Health at Johns Hopkins University School of Public Health. Conflicts of Interest: N.R. is on the Scientific Advisory Board for Clearwater Clinical. F.L. has served as a consultant to Boehringer Ingelheim, Amplifon, and Cochlear Ltd. Author Contributions: A.W. crafted the study concept and design and was responsible for acquiring the data and conducting the analysis. A.W., N.R., and F.L. all contributed to the interpretation of the data and preparation of the manuscript. Sponsor's Role: The Commonwealth Fund and the Cochlear Center for Hearing and Public Health had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Funding Information: Financial Disclosure: This study was funded in part by the Commonwealth Fund (grant 20171061) and the Cochlear Center for Hearing and Public Health at Johns Hopkins University School of Public Health. Publisher Copyright: © 2019 The American Geriatrics Society

PY - 2019/4

Y1 - 2019/4

N2 - Objective: Hearing care services for older adults with hearing aids are underutilized and are not covered by the Medicare program. Little information exists to the value of hearing care services for older adults with hearing aids. The objective of this analysis is to estimate the potential costs and benefits to the Medicare program of covering hearing care services. Design: Cross-sectional analysis using propensity score matching methods to create balanced and comparable groups. We conducted a 1:1 match of older Medicare beneficiaries with hearing aids who self-reported use of hearing care services in the previous 12 months to those with hearing aids who did not use hearing care services. Groups were balanced on demographic and socioeconomic characteristics as well as health status, functional impairment, and trouble hearing. We compared average total Medicare spending per person between matched groups, as well as by service type. Setting: Nationally representative survey of Medicare beneficiaries in the United States (Medicare Current Beneficiary Survey) 2013. Participants: Study participants were limited to those in the survey who reported using hearing aids in 2013 (n = 1120). Results: Average annual Medicare spending was $8196 (95% confidence interval [CI] = $6670-$9723) among Medicare beneficiaries who used hearing care services and $10,709 (95% CI = $8878-$12,541) among matched controls who did not use hearing care services. Total spending per person was $2513 (95% CI = $150-$4876) higher among those who did not use hearing care services, with spending differences driven mostly by higher-skilled nursing facility (difference = $825; 95% CI = $193-$1455) and home health (difference = $287; 95% CI = $7-$568) spending among matched controls. Conclusion: Utilization of hearing care services among older adults with hearing aids is associated with reduced Medicare spending. Increasing access to hearing care services among Medicare beneficiaries with hearing aids may provide value to the healthcare system and net savings to the Medicare program. J Am Geriatr Soc 67:784–789, 2019.

AB - Objective: Hearing care services for older adults with hearing aids are underutilized and are not covered by the Medicare program. Little information exists to the value of hearing care services for older adults with hearing aids. The objective of this analysis is to estimate the potential costs and benefits to the Medicare program of covering hearing care services. Design: Cross-sectional analysis using propensity score matching methods to create balanced and comparable groups. We conducted a 1:1 match of older Medicare beneficiaries with hearing aids who self-reported use of hearing care services in the previous 12 months to those with hearing aids who did not use hearing care services. Groups were balanced on demographic and socioeconomic characteristics as well as health status, functional impairment, and trouble hearing. We compared average total Medicare spending per person between matched groups, as well as by service type. Setting: Nationally representative survey of Medicare beneficiaries in the United States (Medicare Current Beneficiary Survey) 2013. Participants: Study participants were limited to those in the survey who reported using hearing aids in 2013 (n = 1120). Results: Average annual Medicare spending was $8196 (95% confidence interval [CI] = $6670-$9723) among Medicare beneficiaries who used hearing care services and $10,709 (95% CI = $8878-$12,541) among matched controls who did not use hearing care services. Total spending per person was $2513 (95% CI = $150-$4876) higher among those who did not use hearing care services, with spending differences driven mostly by higher-skilled nursing facility (difference = $825; 95% CI = $193-$1455) and home health (difference = $287; 95% CI = $7-$568) spending among matched controls. Conclusion: Utilization of hearing care services among older adults with hearing aids is associated with reduced Medicare spending. Increasing access to hearing care services among Medicare beneficiaries with hearing aids may provide value to the healthcare system and net savings to the Medicare program. J Am Geriatr Soc 67:784–789, 2019.

KW - Medicare

KW - cost-benefit analysis

KW - hearing loss

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Cost-Benefit Analysis of Hearing Care Services: What Is It Worth to Medicare?

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