6 Winning Strategies to Reduce Hearing Aid Returns in 2024

Ever wondered why some hearing aids end up returned more often than used? As a hearing care provider, are you keen to improve your return for credit rate? Join me, Blaise Delfino, in this episode as we explore the world of hearing healthcare and tackle key issues that can help reduce hearing aid returns in 2024.

Brace yourselves as we journey into the nuances of empathetic healthcare and debunk myths surrounding hearing aids. We will address common reasons for returns like unsuitable fit, adjustment challenges and misaligned expectations, while providing practical advice to improve your practice's return for credit rate. Hear from my personal experiences as a private practice owner, and how I learned the importance of patient financing in hearing healthcare.

In this enlightening conversation, we'll also uncover six effective strategies to enhance the return for credit rate. From mastering patient education and communication, to refining the onboarding process and follow-up schedule, we leave no stone unturned. Let's pledge to raise awareness about hearing health, improve patient satisfaction, and make 2024 a successful year for all hearing healthcare providers, students, and consumers. Tune in and let us together create a ripple of change in the world of hearing healthcare.

Transcript

Blaise M. Delfino, M.S. - HIS: 0:06

You're tuned in to the Hearing Matters podcast, the show that discusses hearing technology, best practices and a growing national epidemic Hearing loss. Before we kick this episode off, a special thank you to our partners Cycle, built for the entire hearing care practice. Redux, faster Drier, Smarter, verified Auto-Set, the modern ear cleaning device. Fader plugs the world's first custom adjustable ear plug. Welcome back to another episode of the Hearing Matters podcast. I'm your host, blais Del Fino, and I hope you're all having a wonderful week.

Blaise M. Delfino, M.S. - HIS: 0:48

I personally cannot believe how close Christmas is. This year has absolutely flown by, and I feel like we always say that like this year has flown by, and I just think that there's the radical acceptance that you know what I think the years just fly by, especially when you're having fun in hearing healthcare. If you're listening to this, it might be morning, afternoon, evening, either way. Hello, I am your host, blais Del Fino, and, for those new to the show, thank you for lending your ears and thank you for joining us on our mission to raise awareness of the importance of hearing healthcare. And whether you're a student studying speech pathology or audiology, you're a private practice owner, ent, or even a current or future hearing aid user, we welcome you with open arms and we hope that this platform assists you in making an educated decision regarding hearing healthcare.

Blaise M. Delfino, M.S. - HIS: 1:45

It is the beginning of December and I've been reflecting a lot, especially when I was practicing full time as a private practice owner and hearing instrument specialist. And every December 31st, especially before the new year, I would look at our key performance indicators, most commonly referred to as KPIs, and I would always look at specific numbers, but most importantly our return for credit rate or RFC, and one of the reasons I looked at that was not because to say, oh you know, only 10 patients this year return their hearing aids. That's great To me. When a patient would return their hearing aids, I took that very personally because I love so much what we do as hearing care providers and if a patient were to return their hearing aids, I felt as though I had failed them, especially if they had a severe hearing loss, and I personally learned not to take it personally. We always walk through, but I will say full disclaimer here our return rate was less than 1% and I don't share that to brag or boast or to impress you, but rather impress upon you that I do know what it feels like when a patient returns their hearing aids. Some are not ready, some it is truly a financial aspect, but we learned quickly to reframe how we were speaking with our patients, our service delivery model, our patient experience, and that's why we have, and had, such a low return rate. So again, that number, I looked at that and if we had a low RFC. What that told me is we have happy patients that are telling their friends about their new hearing journey and that's also showing that our team is all walking in lockstep. We're all walking together in the same direction, helping patients hear life's story, and I really felt it in my heart of hearts to talk to you today and discuss ways in which you can reduce hearing aid returns in 2024. Now we are this band of hearing care providers that truly are on a mission to raise awareness of the importance of hearing health care, and we have a lot of work to do. We need to continue to remove the stigma and oftentimes new hearing aid users, when they come into the clinic, they might be a little skeptical and they are going through that grieving process and I can assure you, embodying empathy and displaying to your patients that you are listening and you truly do care about their hearing journey. Everything else is going to fall into place.

Blaise M. Delfino, M.S. - HIS: 4:30

Now, again, I briefly discussed how I felt when a patient would return their hearing aids and the first time I experienced this, I really took it to heart and again, because I really wanted to help this patient. They had severe hearing loss and we discussed different options as well but also understanding that not everyone is ready for technology hearing technology in this case but this is really where motivational interviewing is very important. We always let our patients know and I would personally always let our patients know, especially when they first came into the audiology suite is I'm not here to convince you by any means. I am here to assist you in making an educated decision regarding your hearing health care. Making your patients is essential. Don't try and fit a patient from a position of convincing them, because they are really looking at you as that thought leader, that key opinion leader. Educating the patient is really important.

Blaise M. Delfino, M.S. - HIS: 5:36

To answer a few questions, you know why do patients return their hearing aids in the first place? There's a few reasons why. Either the fit was poor, whether it be a Rick receiver in the canal device or a custom ITE in the ear device the patient couldn't get used to the sound, the patient didn't perceive value or better hearing from the hearing aid slash hearing care provider. And again, this is one that I really want to deep dive into, because if, as a hearing care provider, you are competing on price, you become a commodity. When you compete on value, you become a resource and or the patient may have had unrealistic expectations. But again, this is where the hearing care provider needs to set realistic expectations.

Blaise M. Delfino, M.S. - HIS: 6:25

So we're going to discuss a few ways in which you can reduce hearing aid returns in 2024. I cannot number one, believe we're already going into 2024. I remember what it was like running the practice during the pandemic and it feels like just yesterday that happened. But as your colleague, as someone who is excited for your continued success, whether you are a student, clinician or consumer, I am on your team. I am excited for your continued success, especially in 2024 and beyond. So, ways in which we can improve our return for credit rate. Now, again, we want to have a low RFC rate, a low return for credit rate. If we have 50% of our patients returning their hearing instruments, the problem is probably the individual looking at you in the mirror. We don't want 50, 60, 70% because, again, it's also not the best interest of the patient, but I know that you listening. Right now you have a low RFC rate. So, number one how to improve our return for credit rate Are you, and is your clinic, offering appropriate financing options?

Blaise M. Delfino, M.S. - HIS: 7:39

Now, today, access is a buzzword in the hearing healthcare space. We talk about access to technology, access to hearing healthcare, and we do have many platforms that do provide access to hearing healthcare and hearing care providers, but are you, the hearing care provider, offering appropriate financing options to your patients? There was a study that was conducted and these findings were released on January 2nd 2023. So almost a year ago and it writes Americans are falling short on the savings front. According to the state of personal finance in America 2022, a study conducted by Ramsey Solutions, there's a clear shortfall in personal savings among millions of Americans. The study revealed that 36% of all Americans have absolutely no savings at all and another 19% have less than $1,000 saved. Almost 45% of all Americans have $1,000 or more in savings.

Blaise M. Delfino, M.S. - HIS: 9:31

Now, the reason I bring that up first and foremost, I am a fan of Dave Ramsey and his teachings, especially when it comes to financial literacy. But as hearing care providers, we also have to embody financial literacy, especially if you are running a private practice, because numbers really do tell a story. But one way to reduce your return for credit rate is to offer these appropriate financing options, because what that study just showed us is that there are going to be patients that come to us that do not have liquid funds to pay for their hearing technology. So we need to ensure that we are sensitive to that. We know, as hearing care providers, that the cost of untreated hearing loss is greater than the price of the hearing technology, but we also have to be understanding, in a way, that not every patient, even if they need that premium technology, will be able to afford that. So I challenge you to audit yourself, audit your practice. What financing options are available to my patients? Am I working with an organization like a care credit? What are the terms? I understand as a hearing health care practice, it costs you to offer financing options, but again, that is one of those costs of doing business and reflecting with you and your team who set those price points, ensuring that it is not only fair to your practice but also the patient in terms of what financing options are available, whether it be that 12 month term, 18 month term or 36 month term. So what is going to help the practice, what is going to help the patient and what is going to be that appropriate middle ground? So one way in which you can improve are implementing appropriate financing options to your patients.

Blaise M. Delfino, M.S. - HIS: 11:27

The second way to improve your return for credit rate is implementing motivational interviewing. Are we asking the right questions? I always loved implementing motivational interviewing because number one, you really get to know the patients much deeper than just asking do you have ear pain, yes or no? That's what the patient intake can answer. All of those yes or no questions, those close ended questions. With motivational interviewing, we're really getting deep in terms of those open ended questions. How is this patient feeling? What is their motivation level to engage with hearing technology, to even make the decision today to walk out with hearing technology?

Blaise M. Delfino, M.S. - HIS: 12:17

And when you are implementing motivational interviewing, this is usually when you bring the patient back to the audiology suite before you test their hearing. If the patient brought with them a family member or a spouse, or they had a third party with them. So if you always ask the patient, mrs Smith, what would you like to accomplish today? And that was always the first question I asked, and then I would look to the spouse or the third party and I would ask him or her what would you like to accomplish today? And after that question, pretty much nine times out of ten, the patient would say I've never had a healthcare provider Ask me what I wanted to accomplish at the appointment. And number one you need to be genuinely curious as to why they're here, what they would like to accomplish today, because if they walk out of the clinic feeling as though that they haven't accomplished what they came to accomplish, they're not going to have that sense of fulfillment. So your job as that hearing healthcare provider is to ensure you're providing them that platform to accomplish what they wanted to. Nine times out of ten, especially if it were the husbands, it would say I want to prove to my wife that it's selective hearing and we've heard that so many times. But ensuring that you make them feel comfortable upfront during the motivational interviewing process and you're asking the right questions. And that would then follow up by understanding and asking them what a typical day like is for them, especially as it relates to communication. On a scale of one to ten one being you're not socially active to ten, you're very socially active when would you put yourself today? Well, I'd probably put myself around a four or five. Tell me about your social activity level 10, 15, 20 years ago, before you started to suspect that you presented with hearing loss. Oh, I was out of ten. So now we understand, we know where to go. Now.

Blaise M. Delfino, M.S. - HIS: 14:15

There are patients that may be introverts or ambiverts but again, this motivational interviewing allows you upfront to really deep dive and understand. Is the patient motivated to do something about their hearing? Are they here because their spouse pushed them? You're still going to give this patient 110%. But there are patients who are truly just not ready to take that step towards better hearing. But if that is the case, you, as the hearing care provider, are able to sleep at night and say you know what? I gave my presentation 110% effort. So motivational interviewing. We did one episode with a colleague of mine. I'll link that in the show notes. You can learn a little bit more about motivational interviewing in case presentation.

Blaise M. Delfino, M.S. - HIS: 15:05

A third way that you can improve your return for credit rate is appropriate onboarding and follow-up schedule for the patients just fit with hearing technology and patients who have been wearing hearing aids for 10, 15, 20 years. Now, of course, the patients who have been wearing hearing aids 10, 15, 20 years. They know how to put the hearing aids in, take them out, clean them. I was always part of the camp that well, you know how to do it. We're still going to review how to do it because maybe you change styles and I just want to ensure too, from that cognitive aspect, that you're still able to clean and care for your hearing technology.

Blaise M. Delfino, M.S. - HIS: 15:46

So, when we talk about onboarding and follow-up schedule, first and foremost, when we started in private practice full-time, and especially following graduate school in 2017, we knew that by the year 2020, the majority of consumers would make their purchasing decisions based on the experience that they had, and we asked ourselves and we audited ourselves. Sometimes it's very hard to look, you know, inside the picture or inside the jar. What are we doing right now? That is not the best experience for patients. What can we do? Starting tomorrow? What is that low-hanging fruit that we can start to implement to create the best patient experience possible? And it came down to implementing an onboarding schedule and experience that our patients absolutely love. So what does that look like? When a new patient moves forward with hearing technology? We send them home with a folder that is branded to our practice and then inside that folder we included information about today's visit, information about the technology that they're moving forward with. We included one of our most recent quarterly newsletters so this patient could go home and read more about the hearing care provider and hearing care practice that they're moving forward with.

Blaise M. Delfino, M.S. - HIS: 17:08

And this is really how the Hearing Matters podcast came about, because we started this podcast solely for the patients that we were fitting in the clinic. Because if a patient would go home and have questions, we wanted to record episodes that that patient could go back and listen to, especially if they were moving forward with a specific hearing aid manufacturer we've talked about the different hearing aids available or if they want to understand what we're going to accomplish at their first follow-up. We recorded an episode all about their first follow-up. So, coming into that next that fitting appointment, for example, that patient knew what we were going to cover and what it did is a decreased majority of the questions and I will tell you 80 to 90% of the new patients that we fit with technology whether it was the patient listening to the episode or their spouse or third party majority listened to the episode and it was a lot of fun. Our patients said, wow, like I can't wait to listen to next week's episode. So what you were doing is you were creating an experience and we were creating an experience and a community and a platform for our patients to feel educated, welcomed.

Blaise M. Delfino, M.S. - HIS: 18:20

And there was no smoke and mirrors, right Like as a consumer. Let's just say you go to purchase a new vehicle and the dealership doesn't show you how to use any of the buttons in this car that you know today's vehicles. They look like spaceships now inside. So like what does this button do? What does that feature do? As hearing health care professionals, it is our duty and responsibility to focus on the benefits of the hearing technology first and the feature second. But what does that onboarding schedule look like? So we always, of course, implemented their fitting appointment first follow up, second follow up. If they felt as though that they needed a third follow up, of course, we satisfied that, and then, every six months, we saw them for a clean and check. So we're seeing our patients at least, at least following that onboarding schedule two times a year at least.

Blaise M. Delfino, M.S. - HIS: 19:13

The patients did incredibly well and again, this absolutely positively influenced and impacted our very low return for credit rate. I will tell you. We implemented a system, we created a system, and I was never afraid of Mrs Smith coming back to the hearing care clinic with her manufacturer bag in hand, not wearing the hearing aids, saying I came to return these. What this system and process did, not only for me as a hearing care provider, but for our team, is it increased our confidence. So if we take a look at this, you know you have a low return for credit rate. You're offering appropriate financing options, you're implementing motivational interviewing and you have a system that ensures that the patient is onboarded properly. Just these three things alone. If you implement in the new year, you will see a drastic decrease in your return for credit rate.

Blaise M. Delfino, M.S. - HIS: 20:17

The patients felt part of a program versus a transaction. With our onboarding and follow up schedule, think about the last time you felt as though you were truly heard at a store or a shopping experience. It could be a healthcare provider as well. Did you feel heard? Did you feel part of a program or did you feel as though it was just a transaction? We are human beings and we are socially connected. We are social beings. We want to feel part of something, especially in the hearing healthcare industry. There is no industry like ours. We can never turn our hearing off. It is always on Our patients when they start to sense that decrease in hearing. Oftentimes they may start to experience that loss of self, and that's where grieving comes in.

Blaise M. Delfino, M.S. - HIS: 21:08

If anything, we discuss today the ways in which to decrease your return for credit rate. This is number one. This is really, really important that you create a system and or refine your current system to ensure that the onboarding schedule is first class. We would always follow up too. When a patient was fit with new hearing technology, we sent them a thank you card. It's those little things and that thank you card hand signed, oftentimes hand written, because, if you go back to the basics, we live in a world of artificial intelligence and it's phenomenal technology. The hearing aids use AI and it's friendly AI, but we, as hearing healthcare providers and business owners, private practice owners, cannot lose that human touch. Blaze, I don't have the time I get it. We all have 24 hours in the day. However, can you pre sign some of these thank you cards and your front office staff fill them out? It's those little things and I use this terminology a lot. You've never been bitten by an elephant, but you've been bitten by a mosquito. It's the little things in business and life that really come back to bite us. The fourth way to improve and decrease your return for credit rate in 2024 is drumroll, please.

Blaise M. Delfino, M.S. - HIS: 22:25

Implementation of best practices. We are not going to deep dive into this today because you, as a hearing healthcare provider, know you should be conducting speech and noise testing, video, otoscopy, temponometry, autoacoustic emissions, functional gain testing, real ear measurement. Those are just a few best practices that we, as hearing care providers, should be implementing. When you implement best practices and one of them, absolutely a tool that we've used and continue to use is the use of the AFAB, the abbreviated profile of hearing aid benefit Start to implement that this year. If there's anything that you do this year, like we discussed, I should say in the new year, refine your onboarding and follow-up schedule and really ensure that you're implementing best practices with every single new and current patient. What is that going to do? So how is the implementation of best practices blaze going to reduce my return for credit rate?

Blaise M. Delfino, M.S. - HIS: 23:26

Here's why the patients, when you implement best practice, you know that you are hitting their targets for best speech and understanding. When you do real ear measurement, when you implement temponometry. You know that their middle ear space is functioning appropriately. You know what their speech and noise testing scores are. So what you're going to do is increase, maybe, some of that digital noise reduction. The implementation of best practices allows you to fine-tune the hearing technology, but also understand what additional communication methods do I need to discuss with this patient to ensure that they're hearing to the best of their ability. When you do that, the patient is going to be happy. They're going to feel heard. They're going to feel part of the community with which they once were able to communicate in, but maybe they've recently withdrawn, or the past years have withdrawn, and what they're going to do is tell their friends and family about their new hearing world. And if a friend or family member of this said patient also feels as though that they present with a hearing loss, they're most likely going to call you, which again, a decreased return for credit rate or a low return for credit rate. What that also carries over into is increase in patient referrals, because your patients are happier and your practice is going to continue to help so many community members. Let's talk about the fifth way to decrease return for credit rate and ways to improve this number in 2024.

Blaise M. Delfino, M.S. - HIS: 24:57

Set realistic expectations. This is really really important to do, and the reason why is because when you are working with patients and you're setting realistic expectations, your patients have this guidepost of okay. My hearing care provider told me that the goal of a hearing aid is not to make everything louder, it's to make speech clearer and I am not going to have supersonic hearing with these hearing aids. The hearing care provider also told me that there are sounds that I've heard before that may sound a little louder. The first week or two. Some sounds may sound harsh, but my brain is going to acclimate to this new hearing world.

Blaise M. Delfino, M.S. - HIS: 25:42

I really wanted to talk to you today about you know when you set these realistic expectations. If I were to say, mrs Smith, we need to set realistic expectations here. While the hearing technology today is incredible and you have these amazing features like biometrics and fall detection incredible technology the goal of the hearing aid is to help you understand speech clearer, not only in simple but complex listening situations like a restaurant, bar area or just around family during the holidays, but also the television. So we set realistic technology expectations, we set realistic listening expectations and the patients would always say thank you for doing that, because we also have to understand, too, that this patient has been grieving. They are looking for some relief. If we shoot for the stars for this technology and we over promise what the technology is going to do for them. Number one, it's not in the best interest of the patient because when you set unrealistic expectations, they're going to get frustrated and guess what? They're going to return their hearing aids. Who cares about the return? What I care about is this patient who has been struggling, maybe for a few years, who is now not wearing technology, and we understand the comorbidities linked to untreated hearing loss. So as hearing health care providers, it is our duty and responsibility to set these realistic expectations.

Blaise M. Delfino, M.S. - HIS: 27:11

When you're setting realistic expectations, oftentimes this conversation leads into the patient maybe asking well, how long do I have to try the hearing aids? What we did is we replaced trial period with adjustment period. So we would say, mrs Jones, you have a 30 day adjustment period. What this allows us to do as a team is to ensure that you are satisfied with your new hearing world. We're going to make adjustments to the hearing technology and we're going to track your performance, not only with the hearing technology but from a communication standpoint as well. I would encourage you replace trial with adjustment period.

Blaise M. Delfino, M.S. - HIS: 27:58

Last but not least, the sixth way to decrease your return for credit rate in 2024 and improve this KPI is to recommend appropriate hearing technology. So when you've implemented best practices and the patient has a 92% word recognition score, but they have a severe speech and noise score and they have a very active lifestyle and they're 65, you're most likely going to recommend premium hearing technology. However, that's also where that appropriate financing option comes into place. This is where you talk about the price of the technology, what comes with that, warranty, etc. I'm not going to tell you how to run your business from a warranty standpoint or a pricing standpoint. That is between you and your business only. But when we are recommending appropriate hearing technology and we are leading with high standard of care, what does that mean? What does that high standard of care mean? We need to make the best recommendation for the patient.

Blaise M. Delfino, M.S. - HIS: 29:06

Oftentimes I've heard of stories at different conferences and conventions where providers will say my patients will not spend X amount for premium technology, so I always offer mid to lower tier hearing technology. I can understand the reasoning behind that, but I also believe that you are taking away the opportunity for your patient to hear even better with premium technology. So if you recommend, let's just say okay. Mrs Smith, we know that you present with a significant hearing loss and you told me that you live a very active lifestyle. Your goals are to understand. In restaurants, in meetings, your husband expressed to us that he wants you to hear better when you go out to dinner, when he takes you out to dinner and picks up that bill right. Based on your significant hearing loss, your social activity level and what you would like to accomplish, I am going to recommend the premium hearing solution that we have in the clinic, which costs X, and then what you do is you stop talking and implement wait time. And this is really an episode that we could do separately, talking about recommending appropriate hearing technology. But again just wanted to discuss six tips and tricks to improve your return for credit rate.

Blaise M. Delfino, M.S. - HIS: 30:29

When you do recommend appropriate hearing technology and your case presentation is educational, not transactional. Again, that patient is actually making the decision, as they should be your that guidepost. Oftentimes they're going to move forward with your recommendation. If you change the paradigm of I am providing so much value, this patient is going to hear so much better. They're going to communicate so much better. The goal here as a hearing care provider is to again educate them. We know that they're going to have their technology for quite a few years. Now that's where that appropriate financing option comes into play.

Blaise M. Delfino, M.S. - HIS: 31:09

If the patient truthfully cannot afford premium hearing technology, discuss lower tier technology. But again, you need to then reset those realistic expectations. If you go from a premium to mid level device, well, you have a severe speech and noise score. If we go with the mid level device, this is what you can expect. If you are going into a lower tier technology, please recommend and every provider should be doing this including a remote microphone to increase that signal to noise ratio, and that should be whether it be low, mid or premium technology. So again, six ways to improve your return for credit rate and reduce your RFC, because again, yes, we want to ensure that our practice is thriving and we're able to help as many patients as possible.

Blaise M. Delfino, M.S. - HIS: 32:02

One of the reasons we want to reduce the return for credit rate is because there's millions of individuals out there with hearing loss.

Blaise M. Delfino, M.S. - HIS: 32:11

We want to show up for them every single day and by doing so they are going to be happy patients. They're going to be champions of better hearing and they're then joining our mission to raise awareness of better hearing. So, number one in 2024, we're going to offer appropriate financing options. Number two, we're going to implement motivational interviewing. Three, we're going to implement an onboarding experience and follow up schedule that is first class, and if you're already doing this, continue to do what you're doing. We're going to implement best practices. We're going to set realistic expectations, not only for new patients, but current patients who upgrade their technology. And number six, last but not least, we are going to recommend appropriate hearing technology. Friends, thank you again for joining us for another episode of the Hearing Matters podcast. Today we discussed ways in which we can reduce hearing aid returns in 2024, not because it's what's in the best interest of the practice, but because it is what is in the best interest of the patients. I'm your host, blais Del Fino, and until next time, hear life story.