(0201) A Comparison of Insurance Types in Cochlear Implantation Follow-Up: Is Public Insurance a Protective Factor

Introduction: Cochlear implantation, the gold standard of treatment for profound sensorineural hearing loss (SNHL), requires rigorous otolaryngology and audiology follow-up to maximize patient outcomes. This analysis explores whether insurance type (public or private) influences follow-up with the surgeon after receipt of CI.

Methods: A retrospective chart review of CI patients in greater Memphis, spanning 2020 to 2023, was conducted. Data collected included insurance type, surgery date, and follow-up dates. Patient insurance, classified as public (Medicare and Medicaid) or private, guided the study’s calculation of average follow-up time, standard deviations, total attended follow-ups, and retention rates for each visit.

Results: Among 117 identified CI recipients, 94 were eligible. Public insurance was held by 76.6% (Medicare n = 69, Medicaid n = 3), while 23.4% had private insurance (n = 22). No significant differences were observed in average follow-up visits or the time to follow-up between the two groups. Attrition differences emerged at 3-month and 12-month post-surgical follow-ups. At 3 months, 79.17% of public insurance patients versus 86.36% of private insurance patients attended, and at 12 months, attendance was 51.39% for public insurance patients and 59.09% for private insurance patients.

Conclusions: Insurance type did not significantly affect time to follow-up or overall attendance. Marginal attrition differences, particularly in the public insurance group, were noted at 3 and 12 months post-surgery. Notably, the study group, predominantly with public insurance (76.7%), contrasts with the national average of 65.6% private insurance (US Census Bureau n.d., 2022). Most patients in the study group had Medicare insurance (n = 69), with an average age of 72.12 years, indicating potential under-treatment in specific groups, such as those with private insurance, without insurance, or with non-presbycusis etiologies of SNHL.