The following is an article posted in the
Hearing Journal:
January 2013 - Volume 66 - Issue 1 - pp 8,10
doi: 10.1097/01.HJ.0000425766.03767.13
Article Link
Breaking News: hi HealthInnovations Extends Marketing Push to Veterans
by Shaw, Gina
Fresh on the heels of an order from the Food and Drug Administration to remove a hearing test from its website last spring, hi HealthInnovations is pushing further into the hearing aid market with a new discount program for military veterans and their spouses.
Figure. The hi Healt…
The company, an affiliate of insurance behemoth UnitedHealth Group, made a controversial entry into the hearing aid market in 2011 when it offered direct-to-consumer hearing aids at sharply discounted prices with no out-of-pocket costs to some Medicare Advantage members. (HJ 2012;65[2]:30; see FastLinks.)
Veterans could prove an extremely lucrative market for the company. Hearing aid sales to the Department of Veterans Affairs comprised 20 percent of more than 2.1 million total units sold through September, according to the Hearing Industries Association. (HIA Statistical Reporting Program. Third Quarter 2012.)
Absent its online hearing test, hi HealthInnovations now directs customers to obtain a hearing test on their own and send the results to the company, which will review them and “follow up by phone to recommend an appropriate hearing device.” Buyers can also search by ZIP code on the company’s website for providers working directly with hi HealthInnovations. A search in a 10-mile radius of the Hearing Journal’s New York City office, for instance, yielded three hi HealthInnovations affiliates and more than 30 other facilities.
Customers then receive their preprogrammed hearing aids by mail; they come with batteries, ear tubes and wax guards, and a 70-day money-back guarantee along with programming support from hi HealthInnovations audiologists.
The veteran’s discount is $100 per hearing aid, which the company says brings the price to between $649 and $849 each. “This program is for veterans and their spouses who do not qualify for the Department of Veterans Affairs hearing aid coverage or choose not to use that coverage,” according to the company’s website.
hi HealthInnovations CEO Lisa Tseng, MD, said in a statement that the company’s approach is a response to an identified need for new hearing health service delivery models. “hi HealthInnovations is committed to helping improve hearing health for people nationwide by expanding access, reducing costs, and enhancing awareness of the causes and treatments for hearing loss,” Dr. Tseng said. “According to the Hearing Loss Association of America, [the] American Academy of Audiology, and other hearing-related organizations, the current delivery model needs to evolve to serve consumer needs, and consumers have consistently complained that the high cost of hearing aids represents a significant barrier to treatment.”
The discount is just one aspect of hi HealthInnovations’ marketing strategy. Patricia Ramos, AuD, the director of audiology and rehabilitative services for Doctor’s Hearing and Balance Centers, part of ENT Associates of South Florida, said her state has been blanketed with ads for hi HealthInnovations hearing aids. “I see them constantly,” she said.
Taking down the online hearing test may have addressed the FDA’s concerns with hi HealthInnovations, but it hasn’t erased the problems that the audiology community and many states have with its model. The FDA was not able to comment by press time.
“You wouldn’t fit a prosthesis by mail, would you?” asked Neil DiSarno, PhD, the chief staff officer for audiology for the American Speech-Language-Hearing Association (ASHA). “There’s a huge adjustment to wearing hearing instruments. If your instrument needs an adjustment based on the initial settings programmed in, then you mail it back. But in a typical hearing aid evaluation, a patient may see the audiologist four or five times before the settings of the instrument are ideal for them. Doing that by mail really isn’t optimal, and leaving the audiologist out of the counseling, follow-up, and adjustment piece is really limiting the success that the end user is going to experience.”
hi HealthInnovations does have contracted audiologists that the customer can consult in person, but an audiologist, like Dr. Ramos, who does not contract with hi HealthInnovations, cannot help patients with their hi HealthInnovations hearing aid. That holds true even if the new hi HealthInnovations patient was already Dr. Ramos’ patient. “If they buy a hearing aid through hi Health, we can’t program it,” she said.
Dr. Tseng said hi HealthInnovations, however, does employ a team of audiologists and hearing health professionals nationwide to increase hearing health awareness through testing, fitting, and community outreach efforts. “These hearing professionals are able to meet with patients for personal consultations, hearing testing and fitting, and ongoing support, helping ensure patients receive high-quality care,” she said in her statement.
More and more patients are finding that their UnitedHealth Group plan only covers hearing aids that they buy through hi HealthInnovations. “Patients are coming in to us very confused about what kind of benefit they have,” Dr. Ramos said. “Some of them have a choice about where they can use their benefits, and some don’t.”
The confusion has been so widespread that ENT Associates of South Florida, one of the largest private practice otolaryngology groups in the country, and Doctors’ Hearing and Balance Centers, created a patient FAQ form and acknowledgement for patients to sign. The acknowledgement reads, in part:
“It has been verified that I have a hearing aid benefit through UnitedHealth care. However, this benefit is only applicable to hi HealthInnovations’ online hearing aids. I understand that Doctors’ Hearing and Balance Centers is not a provider or servicer of these hearing aids. I am also aware that the physicians at Ear, Nose, & Throat Associates of South Florida will not document medical clearance for hi HealthInnovations’ hearing aids because their practices do not meet the standard of care established by the state.”
Other practices have taken similar actions. The Benke Ear, Nose and Throat Clinic in Cleburne, TX, posted a patient alert on its website warning UnitedHealth members with hi HealthInnovations hearing aid benefits through Secure Horizons and AARP Medicare Complete from Secure Horizons that their clinic is not contracted with Secure Horizons for hearing aids.
“The new program has affected how we can handle benefits concerning the purchase of hearing instruments,” the announcement reads. “Basically, the new program removes us completely from the process of helping you select the right hearing instrument/s for your particular hearing loss, along with the process of fitting and service to your hearing instrument/s concerning the care and maintenance of your hearing instrument/s.”
hi HealthInnovations may not be afoul of federal regulations now that its online hearing test is down, but state regulations may prove troublesome for the company. No federal law prohibits selling hearing aids by mail directly to consumers, but several states ban the practice, including Oregon, Colorado, Florida, and Texas.
Texas’ two key licensing boards — the State Board of Examiners for Speech-Language Pathology and Audiology and the State Committee of Examiners in the Fitting and Dispensing of Hearing Instruments — issued a cease-and-desist letter to hi HealthInnovations in August, ordering them to stop their current business practices in the state because of possible violations of the state’s laws related to hearing aid dispensing. Dr. Ramos said audiologists and other hearing professionals in Florida are pushing for a similar edict. Dr. Tseng argued, however, that hi HealthInnovations “meets applicable state and federal regulations for the sale and distribution of hearing devices.”
“It’s very simple: hearing aids are, by regulation and state law, dispensed by people licensed to do that,” said Carole Rogin, the president of the Hearing Industries Association. “Certainly an important part of that licensure is the ability, and in fact, the requirement, to inspect someone’s ears.”
ASHA’s Dr. Sarno agreed, adding that hearing aids are an important part but only a part of hearing rehabilitation. “Providing these services largely by mail and in such a fragmented way, without ongoing in-person follow-up, means that you’re going to wind up with a lot of these devices discarded rather than put to good use,” he said.
FastLinks
* More information about hi HealthInnovations’ program for veterans is available at http://bit.ly/SfVmej.
* Read the Hearing Journal article, “FDA Shuts Down hi HealthInnovations’ Online Hearing Test,” at http://bit.ly/UPyAqE.
* The HJ article, “hi HealthInnovation’s Foray into Hearing Aid Market Sparks Controversy,” is available at http://bit.ly/QAfqJY.
* Click and Connect! Access the links in The Hearing Journal by reading this issue on our website or in our new iPad app, both available at thehearingjournal.com.
* Comments about this article? Write to HJ at HJ@wolterskluwer.com.
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© 2013 Lippincott Williams & Wilkins, Inc.
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