Hearing loss is the most common neurological disability in the United States. And the impact of hearing loss on the personal and professional lives of the deaf or hard-of-hearing and on society is profound.
In the United States alone, there are more than 500,000 deaf or hard-of-hearing infants, children and adults with severe-to-profound hearing loss. Over 45,000 people in the U.S. Have benefited from cochlear implants.
Three primary barriers stand in the way for those who might benefit from cochlear implants:
- Lack of Awareness
Cochlear implants do not provide normal hearing. However, for many infants, children, and adults, this safe and proven technology can substantially increase the patient's access to sound and speech information. Unfortunately, there are many patients who do not live near cochlear implant centers and who are uninformed of how a cochlear implant could benefit them – a lack of awareness that denies them access to this life-altering technology.
The cost of cochlear implantation is high, averaging $40,000 to $70,000 per patient. These costs include the medical and audiologic evaluation, surgery, device cost, and the rehabilitation that takes place following surgery. Compensation from insurance companies is often insufficient, causing implant centers and hospitals to lose money on each patient. Not only are the devices themselves poorly reimbursed, but what is underestimated are the costs of the essential audiologic and speech and language care that takes place for months and years after surgery, especially for the infant who is born with no hearing. However, with the appropriate support, deaf infants can enjoy near normal to normal speech and language skills with a cochlear implant.
This seemingly high initial cost, however, is offset by the tremendous payback to society. Studies at Johns Hopkins have proven the cost effectiveness of cochlear implants in children and adults, saving society many thousands of dollars in special education and disability accomodation costs. These benefits continue as mainstreamed children enter college and become productive members of their communities. Unfortunately these clear cost benefits to society are not being recognized by our third party payers, and until reimbursements for this life-altering technology improves, implant programs are at risk or will be unable to provide for a growing number of cochlear implant candidates.
- Shortage of Expertise
There are a shortage of audiologists and speech therapists who have a special expertise in cochlear implantation. Improvements in reimbursement for these services, combined with formalized coursework and training in cochlear implants, will help to reverse this trend.
With advanced screening capabilities and the aging population, this gap continues to grow.
Increased Infant Detection
As newborn hearing screening becomes mandatory for 100% of all infants born in the United States, there will be a tremendous increase in the number of infants identified as cochlear implant candidates.
Studies have shown that children who received cochlear implants are fully mainstreamed faster, at younger ages and at higher rates than those without implants. They also were less dependent on special education services after an average of two years. Cost-utility analyses indicate that if an infant receives a cochlear implant, many thousands of dollars may be saved in special education needs over the life of the child. There are also significant intangible benefits as well - including reduced familial and social stress, higher safety levels, and maximized independence.
The number of adult implant candidates in the United States is rising, especially in the late-deafened adult sector as the baby boomer population reaches retirement age. Noise pollution – the increased volume levels in the work place – has become more prevalent and manifests as premature hearing loss.
And we’re living longer than ever before. As the elderly population grows, so does the need for hearing-restoration technologies. Cochlear implant and emerging technology will contribute to keeping the severely deafened individuals of this age group in the work force until retirement, and help to protect already flagging public disability funds.
Through research grants, education, and advocacy efforts, the Foundation will help bridge the gap for the millions who can benefit from the gift of hearing.