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Audiology faculty assist in expanding Medicare coverage for cochlear implants

Audiology faculty assist in expanding Medicare coverage for cochlear implants

Audiology faculty assist in expanding Medicare coverage for cochlear implants
November 04
14:30 2022

University audiology faculty worked together with the Centers for Medicare and Medicaid Services to update patient criteria for cochlear implants to treat hearing loss, according to a press release.

The team of researchers is led by audiology and speech-language pathology assistant professor Sharon Miller. Working alongside her is Erin Schafer, an audiology professor and the graduate studies director for the College of Health and Public Service and Cassie Thomas, a senior lecturer and clinical director for audiology.

“One of my lines of research is looking at outcomes with people that use cochlear implants – trying to maximize their benefit from the devices, so one of the main variables that we look at is speech,” Miller said.

The newfound Medicare coverage went into effect on Sept. 26 and will expand treatment for older individuals with hearing loss. Cochlear implants were previously only easily accessible to patients with private insurance coverage, who are typically young.

Medicare is the federal health insurance program for people 65 years or older.

“Now that they’ve made it less strict, you know, it will open the door for more people to be candidates [for cochlear implants] because […] we don’t have a choice when we’re 65 in the U.S. to have Medicare — you just have it,” Schafer said. “When you’re really not getting much benefit from a traditional hearing aid, it’s too bad people had to sit around and wait so long to get one.”

Schafer said previous research found adults with Medicare had to wait longer to receive cochlear implants and had poorer outcomes than adults with private insurance.

“So, it just makes it equal,” Schafer. “It really actually is discrimination against older adults to make it stricter for them and less strict for private insurance.”

Cochlear implants are small, electronic devices that amplify sounds to someone hard of hearing or deaf. The implant is made of a part that sits behind the ear and a second part that is surgically set under the skin.

“So, cochlear implants are a device for patients who don’t receive […] benefit from hearing aids alone, so they still struggle with speech perception,” Thomas said. “The cochlear implant hopefully will improve their overall speech.”

Miller’s team helped recommend Medicare to older patients if they received scores between 40 and 60 percent on an open-set sentence recognition test, qualifying them for cochlear implantation. The test assesses their ability to understand spoken language without any visual cues, according to FreeDictionary.com.

“So, when you have losses in the in the cochlea or the inner ear, and when those hair cells get damaged, you have hearing loss,” Miller said. “When those hair cells are so damaged or gone altogether, due to noise exposure, ototoxic medications people take, those are then the patients that are qualifying.”

Hearing aids and cochlear implants may seem similar but differ in many ways. Hearing aids amplify sound for detection by the damaged ears, while cochlear implants go into the auditory nerve for stimulation. The implant generates signals through the auditory nerve directly into to the brain, which acknowledges these signals as sound.

Both hearing aids and cochlear implants offer different benefits for people with a wide range of hearing loss.

“It depends on their level of hearing loss and depends on the patient and how long they’ve had their hearing loss,” Thomas said. “So, patients can’t progress to a cochlear implant until they’ve reached their maximum capacity.”

About 736,900 cochlear implants have been in use as of December 2019, according to the National Institute on Deafness and Hearing and Other Communication Disorders. In the U.S., about 118,100 implants are in adults and 65,000 in children.

“So, there’s a candidacy criterion — we’re becoming a Cochlear Implant Center, actually — for doing the evaluations, but you can get them as a pediatric patient or as an adult,” Miller said. “Now, you can be implanted at the age of nine months, according to the [U.S. Food and Drug Administration].”

Featured Image: The Speech and Hearing Center on Sycamore St. on Oct. 30, 2022. Photo by Ismael Belkoura

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Joaquin Fernandez

Joaquin Fernandez

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