I got lot of mail about my last post on shopping for hearing aids and on how bundling of hearing exams into the end price of a hearing-aid sale can make consumers less likely to try multiple brands before buying.
As it happens, unbundling is a hot topic in the hearing aid business right now. With consumers and hearing-loss support associations advocating for more transparency in the hearing aid sales process, audiologists are looking for new approaches to fitting hearing aids and providing follow-up service. But breaking new ground by moving from the older tried-and-true approach can be a challenging and confusing task, especially as more hearing aid brands come on the market and patients start asking for more information about the differences.
“Unbundling…is not straightforward and interfaces with many other challenges in health care,” one audiologist wrote me. “There are many models, and many of us are going nuts trying to figure it out!”
The problem for the audiologist is getting paid for all the amount of care required in the fitting and follow-up. Charging one price for an expensive pair of hearing aids and providing comprehensive service before, during and after the fitting is an attractive model.
With bundled sales and service, the hearing aid manufacturer sells the hearing aids to the audiologist at a wholesale price, and the audiologist marks up the retail price to compensate for extensive service. The process is simple for consumers, who just have to pay for the hearing aids — when the process works well they get all the service they need. The downside, however, is that consumers don’t know exactly what they are paying for. They don’t know how much the hearing exam costs, how much the fitting costs, how much the earmolds (if needed) cost, and how much the hearing aids themselves cost. Very often the consumer can’t even name the brand or manufacturer of the hearing aids they are wearing, other than to say “They’re what my audiologist gave me.” It makes comparison shopping difficult.
Not knowing exactly what you are paying for is a common problem in healthcare generally. When your cardiologists says you need a stent, do you ask him what brand will be used? If health insurance pays part or all of the cost, do you ask what the cardiologist will charge, what the anesthesiologist will charge, or what your general practitioner charged for the referral? When consumers aren’t educated and fail to ask questions, it’s less likely there will be the kinds of comparisons that lead to more choice and lower prices.
With most hearing aids not covered by insurance, and with demand growing from aging baby boomers losing their hearing at a predictable rate, audiologists are hearing a lot more of these kinds of questions. And many are starting to respond.
One audiology practice, the UNC Hearing and Communications Center at the University of North Carolina, is pioneering the new practice of completely unbundled hearing aid fitting, service and sales, with as much transparency in pricing as possible. Two audiologists from the Center, Barbara Winslow Warren, Au.D., and Stephanie Sjoblad, Au.D., wrote an excellent article about their approach for HLAA’s Hearing Loss Magazine. It’s a must-read for anyone trying to understand the ins and outs of unbundling. Click here–Unbundling of Hearing Aid Costs— to download it.
As with all markets, caveat emptor — buyer beware — should be the watchword for anyone embarking on the quest for better hearing. Perhaps the best advice I got among the emails that came in was from Dennis Hampton, Ph.D., editor of Hearing HealthCare News:
I think it’s a good idea to remember that a person with a hearing loss should be “shopping” for someone who will be their hearing care provider, not for hearing aids. Follow-up care is the critical factor in coping with hearing loss…. There are excellent hearing aid products out there (many with far more technology and bells/whistles than are necessary), and the top products are more similar than different. But the range of professionalism and quality of follow-up care is far greater—and that is what makes the difference.
I couldn’t agree more that anyone who fears they have suffered some hearing loss should get a good evaluation from a certified hearing health care profesional. And I also couldn’t agree more that it’s in your interest to get a second, third, and even fourth opinion, when you are deciding what kind of help to get for your hearing–and from whom. And finally, the more you know about what products are out there, and which brands and manufacturers have products with the features and performance you need, the better prepared you will be to ask the right questions.
As the old saying goes, “An educated consumer is the best customer.”
Ann_C says
As a user of hearing aids for most of my life since age 4, I would certainly welcome the idea of unbundling HA sales from the audie’s professional services. I’m a far more savvy consumer of HA’s than the average HA consumer, researching and comparing HA’s before I even commit to an appointment with an audie’s office, a situation which is not the typical HA consumer scenario. I’ve known for years that audiologist offices typically bundle way more services with the sale of HA’s than I have use for, because I have a stable hearing loss that hasn’t changed much over the years. Others need the professional services more than I would, if they have a new hearing loss or a progressive one, for example.
Audies need to take into account the veteran consumers who really are the bellweather users, the ones who really use aids and have no vanity about shelving them but such users REALLY want aids that WORK for them. Otherwise, the audie is gonna get nothing but grief.
It would be better for my audie to unbundle her services for precisely what I need, and not because of some generic estimate of services. I’d rather my audie earn her living instead of making me feel like I’m wasting my time and money.
Ann_C
Donna says
Nice post. Thanks for the link to the article. Au.D. training programs can lead the way, teaching the next generation of audiologists how to unbundle. I just hope their charges truly cover their costs, instead of being partly subsidized by the university.
A big problem with unbundling is that the procedure codes we can use for the hearing aid services we provide (mostly for billing insurance–which drives private pay billing as well as our fees legally have to be consistent) are not well defined and have not kept current with new procedures/equipment. There isn’t much consistency in how they are used, or much consistency in exactly which procedures or methods are used. So, the how-to-do-this process is difficult. I’m working toward it.