The rise of third-party administrators (TPA) is a stressor for many audiology and ENT practices, with good reason. Third-party insurance is the fastest-growing channel for hearing aid sales, increasing the estimated market share from 15% in 2018 to approximately 25% in 2024. Over the same period, average reimbursement rates through TPAs have been declining. This trend increases pressure on practices to provide competitive hearing aid options, optimize their staffing and scheduling and market to attract a profitable patient base.
This Ask Fuel First section answers, “What are the implications of third-party insurance for attracting and retaining patients? And how can practices maximize their profitability with their marketing efforts?”
This article outlines a three-step process to understanding the implications of TPAs and maximizing profitability for patients with third-party insurance.
Step 1: Consider the Patient Source
The first step is to consider how patients are sourced. A successful marketing strategy increases the chances that a patient with a TPA benefit will come to your clinic directly instead of going through a referral from a TPA. This gives the practice greater flexibility to offer these patients alternative treatment plans, which can increase the profitability of that patient for the practice.
This is especially important in regions where TPAs control most of the market, and it’s typically not worth the financial investment to market specifically to private-pay patients. Instead, we recommend strong marketing with standard demographic targets and a heavier investment in training. Your practice will benefit from front office staff and audiologists equipped to help patients navigate TPA alternative options.
Even for practices that don’t accept TPAs, a consistent marketing strategy can increase overall patient flow and draw in a patient base that is more likely to purchase hearing devices.
Step 2: Be Strategic With Your Database
As with most private practice marketing, your database is a critical resource when responding to the rise of TPAs. Data points, like whether someone historically purchased via TPA or private pay and which insurance they have, allow you to target your campaigns in ways you can’t with new patient marketing.
To make the most of your database, consider the following:
- Private-Pay vs. TPA Segments. Private-pay patients should receive annual clean-and-check reminders, 3+ and 4+ technology upgrade letters, invitations to technology demo events, holiday cards and other practice updates. For TPA patients, scale that back based on your schedule availability. For example, TPA patients could receive holiday cards and newsletters and only get technology upgrade invites at the 4+ and 5+ year mark.
- Differentiate Between Insurance Companies. TPA or not, each insurance company varies in reimbursement rates, frequency of denied claims, administrative time needed to submit claims, etc. Data indicates that TPA patients repurchase on average every 3.7 years vs. 4.7 years for private pay, so this can be a valuable source of recurrent revenue. Patients with favorable insurance for your practice can be treated similarly to private-pay patients. Track how often patients can repurchase under your preferred plans and send reminders as that date nears.
- Prioritize Patients in Their 60s. If you are a multi-specialty practice, patients in their early 60s across your service lines who have not purchased devices through you are excellent targets for education about hearing treatment as they are about to become eligible for Medicare. At age 63, if they still have not purchased, you can provide stronger incentives, like discounts or special offers, to start that relationship with audiology. Similar principles apply to single-specialty practices with tested-not-treated patients in this age group.
- Charge for Non-Billable Services. Ensure that TPA patients are charged for non-billable services to increase the profitability of these appointments.
It’s no secret that database marketing is a valuable source of ongoing revenue. By segmenting with TPAs in mind, you canmore effectively connect with patients at critical moments in their hearing care journey.
Step 3: Connect With New Patients
For new patient marketing, there are several factors you can target to increase your chances of connecting with private-pay patients. These factors include:
- Age. Like with database marketing, patients younger than 65 are significantly less likely to have a TPA benefit because of Medicare ineligibility.
- Income. Patients with a higher income are generally more likely to purchase high-end hearing aids, and some data indicates that patients who make $110k or more are likely to purchase them with private pay even if they have a TPA benefit.
- Employer. Keep an eye out for insurance plans that offer favorable hearing aid or TPA benefits and for any large companies in your area that offer that insurance.
- Behavior. Patients who prioritize their health and/or technology within their budgets are more likely to value the benefits of high-end technology and a premium treatment plan.
When you’re building your external marketing strategy, make sure your basics are in place, such as incorporating the following:
- High-Quality Website. Websites built within the last four years work well on mobile phones and follow ADA and HIPAA best practices.
- SEM Campaign. In most markets, there should be a search engine marketing (SEM) campaign targeting hearing aid and hearing loss searches. You can target or exclude third-party insurance search terms depending on the market.
- Google Business Profiles. Optimize Google Business Profiles under the practice name and per location with regular, positive, relevant reviews for the practice with at least a 4.7-star rating.
- Efficient Call Staff. It may go without saying, but ensure that when those leads call the practice, the front office staff is knowledgeable, polite and efficient and call hold times are not too long. It’s particularly important for the front office staff to effectively handle questions about which insurance is accepted and align their messaging with the practice’s overall strategy.
Once you’ve got your basics covered, there are lots of ways you can utilize this knowledge about TPAs to influence other external marketing efforts. Here are some examples to get started:
- Create a Purchase List Mailer Series. Plan the series and send mailers to the same list three or four times annually to reach middle-income adults in your area who are 63–64 years old.
- Participate in Events. Events that involve a health component, like community fun runs, bike races or health fairs, help with your marketing plan. Hand out compelling collateral and fun, branded promo items. If you partner with an online hearing screener like Shoebox, have an iPad® for patients to take a screening immediately.
- Have a Physician Referral Strategy. Keep income and behavior in mind with your physician referral strategy. Primary care providers in wealthier neighborhoods are more likely to have high-income clientele. Concierge providers who only accept a limited number of patients and require their patients to pay a yearly or monthly fee to work with them will draw patients who highly value their health care. When you find clinics like this, prioritize their patients and make sure you have regular touchpoints with the clinic.
- Partner With a Gym. Partner with a gym or health club with middle-aged and older adult clientele who are ready invested in their health. Run a special promotion offer just for that business or coordinate with the clinic to do free hearing screenings on-site.
- Run a Social Ad Campaign. If a large employer in your area offers an insurance plan you like working with, look at whether social ad campaigns targeting that employer are possible. Depending on company size and activity on Facebook, you may be able to run a marketing campaign specific to that employer.
TPA insurance is on the rise, but there are many tools practices can employ to ensure they deliver excellent patient care without sacrificing their financial goals. With these TPA marketing tips in mind, you can spend your marketing dollars efficiently to meet your clinic’s and your market’s needs. Contact your regional team for more information on marketing to patients with third-party insurance.
