Business Management Considerations: Hearing Health Care Consumerism

There has been a shift in both the manner that providers care for individuals, and the manner that consumers access health care services and providers. In its earliest years, hearing health care was a covenant between a consumer and a provider welded by empathy and commitment. Here, the practice’s success and profitability were linked to the provider’s reputation, underwritten by accountability not only to consumers, but their families and communities.www.shutterstock.com. Consumerism, Silent Generation, Baby Boomers, Gen Xers, Millennials, Gen Z, business management.Figure 1: Consumer purchasing trends and mean disposable income as a function of generation. Consumerism, Silent Generation, Baby Boomers, Gen Xers, Millennials, Gen Z, business management.Over the past two decades, hearing health care has transitioned from the covenant service model into a team-based approach, where care is delivered through a mosaic of providers (i.e., primary, specialty, allied health) under the control of managed care. In this contemporary model, providers balance accountability not only to individuals, but also to health plans and stakeholders (e.g., suppliers, corporate entities). Success, in most instances, is commodity-based, quantified by productivity using metrics, such as billable hours, average selling price, conversion rate, and profitability. More recently, service delivery of care has migrated from a model of professional care to permitting consumer self-care. On October 17, 2022, U.S. legislation went into effect expanding consumer access and availability of non-prescription amplification technology to individuals with perceived mild-to-moderate hearing loss. 1 This legislation empowers this population of U.S. consumers to access hearing health in a number of ways: 2 self-fit, direct-to-consumer (DTC) devices without the need for professional diagnostic services nor treatment support (e.g., Bose) self-fit DTC devices that provide treatment support without professional diagnostic services (e.g., Nuheara) DTCs that provide professional support via telehealth (e.g., Blamey Saunders hears) prescriptive devices online with provider support available via telehealth (e.g., Lively) prescriptive and DTC devices with in-person provider support. CONSUMER DYNAMICS Health Care Consumerism. The shift toward a managed care health care delivery system—where a larger portion of financial responsibility and out-of-pocket costs befall the consumer—and the increase in access to self-care has induced health care consumerism3 Health care consumerism is a movement where individuals take an active role in managing their well-being needs through activities such as researching available treatments, understanding costs, and comparing providers. This means that: Today’s consumer is an active participant when it comes to their health-related well-being. Providers must determine the appropriate intersect between demand and service provision to meet the functional, well-being, and financial needs of the consumer. Generational Considerations. In addition to health care consumerism, there is a lack of understanding among providers and the industry regarding the dynamics of consumer purchasing behavior tied to generational differences. Twenty years ago, consider that most practices were serving primarily adults from the Silent Generation (i.e., born between 1925 and 1945 4). Today, these same practices are serving multiple generations: Baby Boomers (i.e., born between 1946 and 1964 4), Gen Xers (i.e., born between 1965 and 1978 4), Millennials (i.e., born between 1979 and 1995 4), and, now, Gen Z (i.e., born between 1996 and 20104). Why should providers consider generational differences? Because each generation is idiosyncratic in the average amount of disposable income and the manner in which products and services are acquired (Figure 1). For instance, hearing health care, historically, has served individuals from the Silent Generation. This generation cherishes the values of hard work, loyalty, and financial prudency. When it comes to purchasing practices, this generation has limited disposable household income (i.e., $41,969 in 2021 5), is brand loyal, financially savvy and prudent, keen to research their brand options online, and value relationships and trust between consumer and seller. During the buying phase, these individuals prefer brick-and-mortar experiences over online experiences. In contrast, individuals from Generation X (i.e., born between 1965 and 1980 4), are among the most sophisticated and educated consumers today. Members of this generation (i.e., Gen X), despite having the highest mean disposable income (i.e., $102,512), are often conservative in their purchasing behavior. Their conservative purchasing approach is premised on avoiding cognitive dissonance (i.e., buyer’s remorse). For this population, the consumer purchasing journey is often lengthy and complex, beginning with intensive online searches, and shaped perceptually by online reviews and social media content. Drivers that lead to acquisition are predicated on messaging that demonstrates that the product or service meets the lifestyle and functional needs of the individual, that is supported by practicality and proof of performance. Like the Silent Generation, Gen Xers rely on customer service for brand loyalty; however, unlike the preceding generation, Gen Xers are increasingly open to online purchasing, mainly because of convenience, toward brands that meet their expectations. CALL TO ACTION For providers, an immediate call to action is to realize that clinical counseling and marketing messages must be crafted with respect to each generational group. At the same time, providers must determine the service delivery channels frequently accessed by consumers in their local market (e.g., social media vs. telehealth vs. in person) to receive professional services and educational content. A long-term call to action by providers is to evaluate critically their current service offerings (e.g., SWOT analysis) and then evaluate the need for future professional offerings (e.g., tinnitus, balance, pediatrics) and delivery systems (e.g., telehealth, in person) based on the economic environment and the characteristics of the consumer in the local market, and assuring that professionals are practicing at the top of their state’s scope of practice. (Note: Although beyond the scope of this article, readers should note that audiology, in particular, has remained stagnant in expanding its professional scope in hearing care relative to other professions serving individuals with hearing difficulties and balance issues.6) Both the immediate and long-term demand for services should be collected through: 1.) surveys and focus group interviews, and 2.) the application of strategy mapping (e.g., gap analysis, balance score card, competitor analysis). The feasibility to integrate and apply offerings includes: 1.) evaluating and identifying the resources required (e.g., equipment, personnel, interprofessional partnerships), 2.) performing financial projections to forecast and compare expenses and revenues, and 3.) ensuring that professional development needs are met prior to the new service offerings. The success of the new models of professional offerings and service delivery should be quantified and evaluated periodically (e.g., 3-, 6-, and 12-month intervals) and adjusted—including private-pay retail pricing—based on consumer demands and resource feasibility. Thoughts on something you read here? Write to us at [email protected].