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Cost-Benefit Analysis of Hearing Care Services: What Is It Worth to Medicare?
Amber Willink1,2, Nicholas S Reed1,3, Frank R Lin1,3
1Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
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.
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