Baby boomers may joke about the decibel level of those rock concerts they attended years ago, but the truth is, all those years of noise abuse are taking a toll on their hearing. Combine that with younger generations weaned on blasting iPods, and it’s no surprise that today’s employers are encountering rapidly rising rates of hearing loss in the workplace. With evidence accumulating that hearing has an important impact on productivity, it’s time for brokers to think about strategies for amplifying hearing screening and treatment benefits.
Employers need to know that hearing loss is increasingly common in the workplace. According to Sergei Kochkin, executive director of the Better Hearing Institute, “[T]here were 16.3 million people with hearing loss in the U.S. workforce in 2010. That means 60% of people with hearing loss are working. There is a lot that human resource professionals can do to help employees. The result will be improvements in both employee quality of life and in workplace productivity.”
Some of the risk factors for hearing loss are workplace noise, aging and chronic disease. CDC’s National Institute on Occupational Safety and Health points out that work itself is one of the major culprits behind hearing loss — with 4 million people exposed to potentially damaging noise at work each day. And hearing loss is an important cause of workers’ compensation claims, according to the CDC.
Chronic disease is also a factor in hearing loss. Hearing loss has been linked to heart disease, depression and diabetes. For example, diabetes impacts 8% of the population and people with diabetes are twice as likely to have hearing loss as those without, according to diabetes.org. The longer a worker has diabetes, the higher the risk of hearing loss.
Importance of hearing to employers
So, why should brokers talk with their clients about hearing loss? Well, employers should care for a lot of reasons, including employee job effectiveness, workplace productivity, and not the least, the Americans with Disabilities Act. As Laurel A. Christensen, Ph.D., chief audiology officer and vice president, research and development of the GN ReSound Group says, “It’s all about better communication for employees — with customers, co-workers and bosses. Employees who can hear won’t miss communications with the customer — and the employer will have more fully functioning employees who do the safest, best possible job.”
Let’s take a closer look.
Job effectiveness: Can you imagine trying to explain a complex task to a worker who only hears 60 to 80 percent of what’s said? That’s what it’s like for managers trying to communicate with workers who have partial hearing loss. It’s not easy from the employee’s perspective either. Workers who cannot communicate effectively with supervisors and peers are more likely to withdraw and be depressed which also hurts productivity, according to the American Academy of Audiology.
Workplace productivity: Closely related to job effectiveness are workplace productivity and the ability of the person to work. According to BHI, people with untreated hearing loss lose as much as $30,000 in income annually, depending on their degree of hearing impairment. That translates to $176 billion dollars lost annually, according to “The efficacy of hearing aids in achieving compensation equity in the workplace,” published in The Hearing Journal. Not to mention to the potential loss of federal unemployment and other tax revenue.
ADA: The ADA requires employers with “15 or more employees to provide qualified individuals with disabilities an equal opportunity to benefit from the full range of employment-related opportunities available to others.” This is perhaps the strongest argument for an employer to have a program that ensures workers with hearing loss are identified and reasonably accommodated.
Benefit Mandates: The Hearing Network Alliance reports that 19 states mandate some form of benefit coverage for hearing aids for children. New Hampshire and Rhode Island mandate coverage for adults as well. While all of the state mandates have slightly different definitions for the target population and the defined benefit, mandates show that policy makers recognize the importance of insurance coverage for hearing care.
How can health benefit professionals help clients to promote hearing health to improve worker productivity? First, it’s helpful to understand the process of diagnosing and treating hearing loss. Then it’s important to look at how benefits can be applied to treatment and analyze whether the benefit is adequate to meet the need.
Identifying and treating hearing loss
Screening: Screening is the first step for identifying a hearing loss problem. Screening can be carried out by hearing health professionals, including audiologists, primary care or ear, nose and throat physicians. Primary care docs don’t routinely screen for hearing loss, so patients need to request it.
Diagnosis: Experts recommend that patients with hearing loss detected by screening have an examination by a doctor to determine if there is a treatable medical reason. A hearing loss diagnosis is made by an audiologist or a physician. Diagnosed hearing loss can be characterized as mild, moderate or severe; treatment depends on the type and severity of the loss.
Accommodation: Employees with mild hearing loss can often be helped by making an accommodation in the workplace. For example, some accommodations might include moving the worker to a quieter location, installing amplifiers on the phone, or increasing use of written communications.
Amplification: For employees with more serious hearing loss, amplification through hearing aids may be needed. Hearing aids come in several price ranges and varieties featuring different designs, technologies and special features (such as the ability to screen out noise). Finding the right device and fit is critical to ensure effective use, and these services should be part of covered treatment.
What brokers can do
Until fairly recently, hearing screening, diagnosis and treatment with hearing aids has not been well reimbursed by insurance. Hearing testing was often only covered as an insurance benefit when a specific problem — such as ringing in the ears — occurred. Financial barriers are slowly beginning to crumble. The Federal Employee Health Benefit Program now encourages all of its health plan carriers to offer a hearing benefit. Blue Cross Blue Shield plans participating in FEHBP in 2009 began covering hearing aids for adults. Plans now offer up to $1,250 per ear every three years, up to $2,500 in benefit and also cover children’s hearing services, according to Consumer Reports Health and Kaiser Health News.
Benefit strategies, while not mandatory in most states, must still make good business sense for employers. Brokers have multiple options for bringing a hearing benefit to customers. Options include:
• Discount arrangements, in which the employer arranges for discounted services to employees;
• Voluntary arrangements, in which an insured benefit is offered to the employee, but as an option that must be fully paid by the employee; or
• Integrated benefits, which offers the employee coverage for specified services or a specified dollar amount in a given time period.
Adding a hearing benefit may be a relatively low-cost strategy to improve both retention and productivity in the workplace. Typical benefits may include an allowance of $1,000-$1,500 in hearing aids per ear every three years, plus coverage of diagnostic testing and professional fitting. While there is little published information about uptake, estimates range from .31% per year to 1.34% per year, depending on the age of the covered population and the relative value of the benefit, according to audiologyonline.com.
Brokers who want to better understand the opportunity and value of hearing benefits for their clients can take the following steps:
• Work with employers to understand the potential impact of hearing loss on employees. Factors to consider include employees’ age, prevalence of co-morbid conditions (particularly diabetes), screening data, and job environment;
• Help employers create a corporate climate where hearing loss is acceptable. Employers can offer easy accommodations such as phone amplifiers and sound barriers, and can also encourage employees to be screened for hearing loss.
• Examine existing coverage of hearing screening and hearing aids in corporate insurance plans.
• Identify a range options for paid or voluntary hearing benefits available to employers, including insured offerings, flex-spending accounts, discounts and other arrangements.
• Consult with hearing benefit providers to determine if innovative ancillary product bundles or offerings are available.
Implementation of health care reform is likely to prompt employers to take a good look at health benefits to determine how they align with mandated “essential” benefits. This provides an excellent opportunity to evaluate how well ancillary benefits align with the needs of the employed population.
Ultimately, addressing hearing loss will improve the health and productivity of workers and will improve employee job performance. Hearing health improvement is an important, attractive and effective employee talent recruitment and retention strategy in this era of the aging workforce.
Greenberg, RN, MPH, is a health policy consultant in Washington, D.C. Her clients include the Hearing Network Alliance and health insurance trade associations.
