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.

成人助听器保险覆盖范围要求对使用率的影响 抽象的 在美国，23% 的 12 岁及以上人群患有听力损失。超过 2/3 的美国 12 岁以上成年人患有听力损失。 70 人有严重听力损失。对于大多数有听力的人来说最有效的管理选择 听力损失是指使用助听器（即佩戴在耳内或耳后的小型可移动电子设备） 放大声音），可以改善沟通和生活质量。助听器一般不在承保范围内 大约 86% 的听力损失病例没有得到治疗。但是，医疗补助计划提供助听器 28 个州的福利和 8 个州要求至少为某些成年人提供私人保险福利。这些覆盖范围 要求可能会通过降低成本作为障碍来提高助听器的采用率。我们的长期目标 研究议程是了解改善听力对健康的影响。具体来说，我们的目标 目前的应用是使用准实验（例如，双重差分）评估方法来估计 医疗补助和私人保险计划的承保要求对助听器使用的影响。我们将使用 高质量、可重复的 Anthem 私人保险索赔数据、国家健康访谈调查 (NHIS) 数据、 与医疗补助索赔相关的 NHIS 数据和医疗保险当前受益人调查 (MCBS) 数据用于研究：(i) 助听器国家私人保险承保要求对受益人购买助听器的影响 以及全额保险健康保险计划中的自付费用； (ii) 医疗补助和私人医疗补助的影响 NHIS 中使用助听器的保险承保要求，以及 NHIS 中的医疗补助承保要求 与 Medicaid 相关的 NHIS 和 MCBS（适用于双重资格）； (iii) 私人和医疗补助的影响 人口群体的要求。我们的项目意义重大，重点关注未治疗听力的高比例 损失;通过估计国家实施私人和公共保险覆盖要求的影响 关于美国成年人采用助听器的情况（这为悬而未决的国家政策的影响提供了证据） 立法）;并通过提供证据证明助听器覆盖范围要求是否得到改善 记录了男性、少数种族/族裔和受教育程度较低的人在使用助听器方面的差异。 我们的项目是创新的，因为它是第一个使用准实验双重差分方法（ 可以为听力保健研究提供因果证据，包括解释的新方法 治疗效果异质；利用当前未充分利用的强大数据源来研究听力 医疗保健的获取和利用；通过原始保单构建详细的覆盖需求数据 我们将公开提供的研究。研究团队包括临床听力学、健康学等领域的专家 经济学、高级统计模型、保险索赔数据和健康政策。拟议的项目将 产生积极影响，因为解决了负担得起且可获得的听力保健服务的系统障碍 有潜力减少差异并增加使用。