The byline that would have more accurately reflected the state of our industry by saying, “Verification and Validation: The Chasm Between Academic Audiologies Best Practice Protocol Fantasyland, and Actual, Real World, Market Value Reality.”
Outside of the cloistered academic Ivory Towers of Audiology publishing, where these “best practice protocols” and “verification and validation” procedures are developed, debated and espoused as professional doctrine, the reality is quite different in the real world.
Apparently, these esteemed academics have been so busy deciding what’s best for everyone else, in every fitting, by declaring and establishing minimum standards of practice, and writing about lack of compliance to their fantasy world standards, that they’ve ignored the true market value of their proposed standards and protocols, when tested against what anyone will actually pay for them.
The realities on the ground are that while the academics and professional associations may effectively write ever higher minimum practice protocol standards for the delivery of hearing aids, even writing them into state laws, establishing licensing etc, the facts on the ground today are that those things just don’t matter in today’s marketplace like they did in the past.
While raising the standards, minimum entry level education permitted to practice, establishing licensing, disciplinary standards, fines, penalties and promises of protecting the public, the market, equipment, communications and consumers have evolved in a different direction.
Professional societies, such as the International Hearing Society, American Academy of Audiology, their state affiliates, boards and others, who have driven the delivery system into a more and more highly regulated, rigid, medical model, now find all of their rules, standards and regulatory boards and licenses irrelevant.
The information disparity needed to perpetuate the current, highly regulated, strictly restricted, medical market delivery system, has simply broken down with the advent of the Internet, programmable, modular instruments, their connectivity with other devices, and an evolution in the sophistication of the consumers who purchase hearing aids.
If, you have been following my writing, this is covered ground. De-regulation and redesign of the delivery system around the potentials offered by bringing open platform and application based communications potential down to the consumer level via unbundled delivery of professional services, and real consumer choice in the matter, are long overdue.
The entire industry now faces the conjunture of forty years of pursuing a medical model of dispensing a product who's capabilities, costs and variety of day to day applications has evolved far beyond it's academic, or regulatory intent, with an evolving disruption by both an outside entity, and a real evolution in how all consumers shopping and buying habbits are changing at an accelerating rate.
Continuing the current antiquated regulatory framework and dispensing model, in the face of these changes denies the realities of how consumers purchase all healthcare, insurance and the things they deem everyday items in their lives.
With the alliance of AARP and United Healthcare, the nation’s largest Senior marketing organization and largest health insurer, respectively, and United’s decision to enter the hearing aid market by selling directly to consumers through their own Health Innovations hearing aid web site, the protocols, minimum standards with their verification and validation, become irrelevant anachronisms of a bygone era consigned to research and academia.
The actual current market value of the validation and verification protocols so highly treasured by academic audiology, have a current street value of $0 dollars. As does the Hearing Aid Specialist License I’ve maintained for the past thirty years.
When a pair of organizations with a combined gross revenue in the range of twenty, to twenty five times the size of the entire hearing aid industry, looked at the way hearing aids were being delivered they saw opportunity not bounded by the academic, or licensee viewpoint.
With exemption from antitrust restrictions and with a mandate to lower healthcare costs overall, AARP and United Healthcare simply redesigned the hearing aid delivery system in their own image. With the ability to offer a hearing aid benefit bundled into their policies and the AARP seal of approval, United purchased Health Innovations and quietly made them the sole authorized vendor for hearing aid benefits under their policies.
By doing so, United deftly moved all of those hearing aid fittings normally done by audiologists and hearing aid specialists, using various manufacturers equipment to a model that funneled all hearing aid claims paid out into the pockets of their own subsidiary.
By doing so, United deftly avoids the profit limiting constraints of the 85/15 provisions of Obamacare that require that no more than 15% of premium dollars may go to administration, marketing or the profits of a health insurer.
By purchasing their very own subsidiary supplier and disqualifying everyone else, all claims paid to Health Innovations in redemption of the hearing aid benefit in their policies along with the required co-pay deductible go directly to Health Innovations accounts, outside of the 85/15 restrictions of the law.
Simply ignoring all the various state regulations and dealing directly with their insureds via the Internet, United and AARP establish a de facto double standard, where those Manufacturers, Dispensers and Audiologist operating within the constraints of local regulations, minimum standards and such, are put at an extreme disadvantage both tactically, and economically.
Given that the IHS, AAA and other professional associations already had their attorneys draft and serve cease and desist, we’re really mad with you letters last year, we can see now their effectiveness. This insurance giant simply looked at the fact that their gross revenues were greater than ten times that of the entire hearing aid industry and decided not only to enter the market, but to redefine the entire delivery process in a way most suited to themselves.
Under the Do-It-Yourself dispensing model implemented, Health Innovations is even advising consumers that they can get the hearing test needed for them to program and set up their hearing aids, by visiting their local hearing aid specialist who they are informed, will do it for free. Consumers are then advised to simply forward their audiogram along with their co-pay and deductible, and wait for their hearing aids to be delivered via common carrier.
By completely eliminating those professional fitting protocols, and the follow up verification and validation protocols so vociferously espoused by our academic audiologists from their entire model, the worlds largest health insurer has valued, and validated the true value of these professional protocols, and the services held so dear, in the actual real world marketplace. Their actual market value assigned, zero.
So, our professional associations have the choice of recognizing that there is an entirely different delivery system, in reality, than the one they desire, and espouse on the ground now, than is being portrayed in their professional halls, publications, and regulations, or risk an ever and ever greater irrelevance, as the actual market dictates the values of what academia and the societies espouse.
Anyone who does not recognize that a paradigm shift has occurred in the hearing aid marketplace and delivery system, either lives in an academic dream world, a cloistered clinic or on another planet.
The hearing aid industry outside of United’s, Health Innovations choice is clearer than ever. These real world changes are upon us right now, the time to evolve the delivery system and deregulate is past due.
To continue to attempt to compete within the constraints of current regulations when the largest Insurer in the Nation simply ignores them, dooms the industry as we know it today to extinction.