A September 23, 2026 Original Research paper in Frontiers in Audiology and Otology describes a retrospective county-level analysis of Medicare hearing-related billing from 2017–2021. Its methods distinguish geographic concentrations of billed activity from population-normalized descriptions of that activity.
The authors state that the billing data locate claims at provider practices rather than beneficiaries’ homes. A resident traveling to another county can therefore contribute activity outside the home county. The paper identifies this potential bias without tracing individual patients’ journeys.
The authors use raw county service or payment totals for their primary spatial clustering. Their separate descriptive per-capita measures divide by total county population, including all ages. Those ratios therefore use a different population from a denominator restricted to Medicare beneficiaries.
The study also excludes counties without billing activity for the selected procedure codes from spatial analysis. Its code selection retains services with complete coverage across the study years. The authors acknowledge that these choices condition the analysis on provider presence and favor stable services.
For ENT readers, these boundaries matter before interpreting a geographic pattern as evidence about hearing-care need. The authors say their public-use data do not support beneficiary-level linkage. County-level billing and demographic comparisons therefore cannot establish an individual resident’s use of care.
Original ENT Daily Dispatch methods account of Jeffrey Li, Vinay Veluvolu, Mark Nyaeme and Mitchell Heuermann, “Geospatial analysis of hearing-related services utilization among Medicare beneficiaries, 2017–2021,” Frontiers in Audiology and Otology, September 23, 2026, DOI 10.3389/fauot.2026.1885939, CC BY 4.0. Paraphrased; no endorsement implied.
The location of billed activity and the population used to normalize it determine what a county-level service comparison can describe.
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Original research ↗CC BY 4.0 ↗This methods explainer describes public reference records. It does not establish study results, a product’s current authorization or treatment suitability.
