Effect of Hearing Aid Insurance Coverage Requirements for Adults on Utilization

成人助听器保险覆盖范围要求对使用率的影响

• 批准号: 10580088
• 负责人: Michael Pesko
• 金额: $ 17.85万
• 依托单位: GEORGIA STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2023-09-01
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10580088
• 关键词: Accounting; Address; Adopted; Adoption; Adult; Affect; Age; Area; Audiology; Awareness; Clinical; Communication; Control Groups; Cost Sharing; Data; Deductibles; Disparity; Ear; Economics; Education; Electronics; Eligibility Determination; Ethnic Origin; Evaluation; Federal Government; Frequencies; Goals; Health; Health Care Research; Health Insurance; Health Policy; Healthcare; Hearing; Hearing Aids; Individual; Insurance; Insurance Benefits; Insurance Claim Review; Insurance Coverage; Interdisciplinary Study; Link; Low income; Medicaid; Medicare; Methods; Mission; Modeling; Modification; National Health Interview Survey; Outcome; Policies; Policy Research; Population; Privatization; Public Health; Quality of life; Quasi-experiment; Race; Reporting; Reproducibility; Research; Services; Source; State Government; Statistical Models; Statutes and Laws; Subgroup; Surveys; System; Unemployment; United States National Institutes of Health; Variant; aged; beneficiary; burden of illness; cost; disability-adjusted life years; disparity reduction; dual eligible; efficacious treatment; ethnic minority; health care availability; health care service utilization; health economics; health plan; hearing impairment; hearing loss treatment; improved; innovation; insurance claims; insurance plan; male; normal hearing; payment; programs; public health insurance; racial minority; sex; sound; treatment effect; uptake

Effect of Hearing Aid Insurance Coverage Requirements for Adults on Utilization Abstract Hearing loss affects 23% of those aged 12 and older in the U.S. More than 2/3 of U.S. adults over the age of 70 have significant hearing loss. The most efficacious management option for most individuals with hearing loss is the use of hearing aids (i.e., a small removable electronic device that is worn in or behind the ear to amplify sound), which can improve communication and quality of life. Hearing aids are generally not covered by insurance and about 86% of hearing loss cases go untreated. However, Medicaid provides hearing aid benefits in 28 states and 8 states require private insurance benefits for at least some adults. These coverage requirements may improve hearing aid uptake by reducing costs as a barrier. The long-term goal of our research agenda is to understand the effects of improving hearing on health. Specifically, the objective of our current application is to use quasi-experimental (e.g., difference-in-differences) evaluation methods to estimate the effect of coverage requirements in Medicaid and private insurance plans on hearing aid use. We will use high quality, reproducible Anthem private insurance claims data, National Health Interview Survey (NHIS) data, Medicaid claims-linked NHIS data, and Medicare Current Beneficiary Survey (MCBS) data to study: (i) the effect of state private insurance coverage requirements for hearing aids on beneficiary hearing aid purchasing and out-of-pocket payments in fully-insured health insurance plans; (ii) the effect of Medicaid and private insurance coverage requirements on use of hearing aids in the NHIS, and Medicaid coverage requirements in the Medicaid-linked NHIS and MCBS (for dual-eligibles); and (iii) the effect of private and Medicaid requirements by demographic group. Our project is significant by focusing on high rates of untreated hearing loss; by estimating the effects of state implementation of private and public insurance coverage requirements on hearing aid adoption among U.S. adults (which provides evidence for the effects of pending national legislation); and by providing evidence on whether hearing aid coverage requirements improve well- documented disparities in hearing aid use for males, racial/ethnic minorities, and lower-educated individuals. Our project is innovative by being the first to use quasi-experimental difference-in-differences methods (which can provide causal evidence) for hearing health care research, including newer methods accounting for heterogeneous treatment effects; leveraging powerful sources of currently under-used data to study hearing health care access and utilization; constructing detailed coverage requirement data through original policy research that we will make available publicly. The research team includes experts in clinical audiology, health economics, advanced statistical modeling, insurance claims data, and health policy. The proposed project will have a positive impact because addressing system barriers to affordable and accessible hearing health care has the potential to reduce disparities and increase use.

助听器保险覆盖范围要求成人利用的影响 抽象的 在美国，听力损失影响了23％的12岁及以上的年龄较大的美国成年人的2/3 70有明显的听力损失。对于大多数有听力的人来说，最有效的管理选项 损失是助听器的使用（即，在耳朵内部或耳朵后面或 放大声音），可以改善生活质量和生活质量。助听器通常不涵盖 根据保险，约有86％的听力损失案件未经治疗。但是，医疗补助提供助听器 在28个州和8个州的福利需要至少一些成年人的私人保险福利。这些覆盖范围 要求可以通过降低成本作为障碍来改善助听器的吸收。我们的长期目标 研究议程是了解改善听力对健康的影响。具体而言，我们的目标 当前的应用是使用准实验性（例如，差异差异）评估方法来估计 医疗补助和私人保险计划中覆盖范围要求对助听器使用的影响。我们将使用 高质量，可重现的国歌私人保险索赔数据，国家健康访谈调查（NHIS）数据，数据， Medicaid索赔与NHIS的数据和Medicare当前的受益人调查（MCB）数据：（i） 国家私人保险覆盖助听器对受益人助听器采购的影响 以及全额保险的健康保险计划中的自付费； （ii）医疗补助和私人的影响 在NHIS中使用助听器的保险覆盖要求，以及医疗补助的覆盖范围要求 与医疗补助联系的NHIS和MCB（用于双重划分）； （iii）私人和医疗补助的影响 人口组的要求。我们的项目非常重要，专注于未经治疗的听力率 损失;通过估计国家实施私人和公共保险覆盖范围要求的影响 在美国成年人中采用助听器的方面（这为待定国家的影响提供了证据 立法）;并提供有关助听器覆盖范围要求是否改善良好的证据 有记录的男性，种族/族裔少数民族和受过较低教育的人的助听器使用差异。 我们的项目是第一个使用准实验差异方法的方法（哪些 可以提供因果证据）听力医疗研究，包括较新的方法 异质治疗效果；利用当前使用不足的数据的强大来源来研究听证 医疗保健访问和利用；通过原始政策构建详细的覆盖范围要求数据 我们将公开提供的研究。研究团队包括临床听力学专家 经济学，高级统计建模，保险索赔数据和卫生政策。拟议的项目将 产生积极的影响，因为解决负担得起且可访问的听力保健的系统障碍 有可能减少差异并增加使用。