What happens when clinical evidence expands faster than Medicare coverage policy? 

Meet Dr. Maura Cosetti, Director of the Ear Institute at the New York Eye and Ear Infirmary of Mount Sinai and one of the nation's leading cochlear implant surgeons. As a leader of the American Cochlear Implant Alliance's effort to expand Medicare coverage for single-sided deafness (SSD) and asymmetric hearing loss (AHL), Dr. Cosetti has spent the last several years working directly with CMS to address one of the most significant access barriers in cochlear implant care today. 

What You'll Hear: 

• The Medicare Gap: Why patients with single-sided deafness are often told to wait until their better ear declines before qualifying for coverage, despite growing evidence supporting earlier intervention 

• Inside the CMS Process: A behind-the-scenes look at the multiyear effort to expand Medicare coverage, including what evidence CMS requested and why the process has taken longer than many expected 

• The Real-World Evidence Challenge: Why gathering Medicare-specific outcomes data is more difficult than it sounds when many eligible patients cannot access treatment in the first place 

• Candidacy vs. Coverage: The critical distinction between being a cochlear implant candidate and qualifying for insurance coverage, and why confusing the two has delayed care for countless patients 

• The Testing Debate: How clinicians are interpreting current Medicare guidelines, including the 60% word recognition threshold, best-aided testing, and ear-specific evaluation 

• Why Traditional Outcomes Don't Tell the Whole Story: The limitations of conventional speech testing for SSD patients and the growing importance of quality-of-life, tinnitus, and functional hearing outcomes 

• The Access Problem: Why fewer than 10% of cochlear implant candidates ultimately receive an implant, and how Medicare policy represents just one piece of a much larger challenge 

Dr. Cosetti offers a practical perspective on what providers can do today while broader policy changes remain under review. She also explains why access, not technology, remains one of the greatest barriers facing cochlear implant candidates. 

Who should listen? 

Audiologists, otolaryngologists, neurotologists, hearing healthcare professionals, primary care providers, students, residents, fellows, healthcare administrators, policymakers, and anyone interested in improving access to hearing healthcare. 

If you've ever struggled to explain the difference between candidacy and coverage, wondered why Medicare has not kept pace with clinical evidence, or questioned how policy decisions impact patients sitting in front of you every day, this episode provides valuable insight from one of the leaders helping shape the future of cochlear implant access. 

Stay up to date with us: LinkedIn, Facebook, and Instagram @MedAudPro 

Want to learn more about FCOM? https://FCOMnow.com 

Join the MedAudPro Provider Community for free access to behind-the-password content and connect with providers practicing at the top of their game: https://medaudpro.com/register 

This episode is sponsored by Envoy Medical. 

What if every month of waiting actually costs a child their future voice?

In pediatric cochlear implant care, time is not just a factor - it is the factor. The window for neuroplasticity is open from birth, and for children with congenital hearing loss, it starts closing earlier than most providers realize.

Meet Dr. Melissa Hall, AuD, CCC-A/SLP, audiologist and cochlear implant team coordinator at UF Health and Clinical Associate Professor at the University of Florida. Dr. Hall holds dual certification in audiology and speech-language pathology, and brings a deeply personal connection to the technology through her husband, who is a bilateral cochlear implant recipient.

In this episode, we take on the clock - and ask what it actually takes to move fast enough to give every child their best chance.

What You'll Hear:

• Why children born with hearing loss are already behind at birth - and what that means for every delayed referral
• Current FDA age minimums, why Dr. Hall believes we can go younger, and what objective testing makes that possible
• Where the newborn hearing screening pipeline breaks down after hospital discharge
• How insurance-driven hearing aid trial requirements bottleneck children who will not benefit from amplification alone
• How to counsel families who want to wait for the next breakthrough - and why waiting is itself a choice with consequences
• What Dr. Hall's husband's experience as a late-implanted bilateral CI recipient teaches families about early intervention

Dr. Hall's message for every provider, regardless of specialty: no referral is a bad referral. If you are not sure, send them.

Who should listen?

Audiologists, otolaryngologists, neurotologists, pediatricians, neonatologists, primary care providers, speech-language pathologists, nurse practitioners, physician assistants, newborn hearing screening coordinators, early intervention specialists, and anyone involved in the care of children with hearing loss.

If you have ever wondered whether a child in your practice might have been identified sooner, referred faster, or implanted younger - this conversation is for you.

Stay up to date with us: LinkedIn, Facebook, and Instagram @MedAudPro

Want to learn more about FCOM? https://FCOMnow.com

Join the MedAudPro Provider Community for free access to behind-the-password content and connect with providers practicing at the top of their game: https://medaudpro.com/register

This episode is sponsored by Envoy Medical.

What if hearing loss isn't just about hearing?

For decades, hearing loss has often been viewed as a quality-of-life issue or simply part of aging. But what if we've been framing it all wrong? What if untreated hearing loss is actually a whole-body health issue with consequences that extend far beyond communication?

Meet Dr. Richard Gurgel, MD, an NIH-funded surgeon scientist at the University of Utah whose research focuses on the relationship between hearing loss, cognition, and cochlear implantation. Dr. Gurgel is known for his work on the influential Cache County Study, which helped demonstrate that older adults with hearing loss experience higher rates of dementia and faster cognitive decline. His latest work examines the long-term impact of cochlear implantation on cognitive outcomes over five years.

In this episode, we explore one of the biggest questions in hearing healthcare today: can treating hearing loss actually change the trajectory of brain health?

What You'll Hear:

· Hearing Loss as a Medical Condition: Why hearing loss should no longer be dismissed as a normal part of aging

· The Brain Health Connection: How hearing loss is linked to cognitive decline, dementia risk, social isolation, falls, depression, and overall health outcomes

· Five-Year CI Outcomes: What long-term data reveals about cognition after cochlear implantation

· Stability Is a Win: Why maintaining cognitive function in older adults may be one of the most important outcomes in medicine

· Beyond Communication: How cochlear implants may support healthy aging through social engagement and brain stimulation

· The Screening Challenge: Why hearing screening still has not become standard practice in primary care

· Reframing the Message: Moving from fear-based counseling toward conversations focused on healthy aging and quality of life

· Demystifying Surgery: Why cochlear implantation may be safer and less invasive than many patients and providers assume

· Local vs General Anesthesia: Emerging approaches that may reduce barriers for older adults considering implantation

· Awareness Is the Real Bottleneck: Why technology may not be the biggest challenge anymore

Dr. Gurgel challenges the field to think bigger. The question is no longer whether hearing loss matters. The question is whether healthcare is ready to treat it like the medical condition it truly is.

Who should listen?

Audiologists, otolaryngologists, neurotologists, primary care providers, geriatricians, neurologists, nurse practitioners, physician assistants, hospital administrators, and anyone interested in the connection between hearing, cognition, and healthy aging.

If you've ever wondered whether treating hearing loss can impact more than communication, this conversation may change how you think about hearing healthcare altogether.

Stay up to date with us: LinkedIn, Facebook, and Instagram @MedAudPro

Want to learn more about FCOM?
https://FCOMnow.com

Join the MedAudPro Provider Community for free access to behind-the-password content and connect with providers practicing at the top of their game:
https://medaudpro.com/register

This episode is sponsored by Envoy Medical.

How many cochlear implant candidates are current hearing aid patients being seen in audiology and ENT clinics right now without anyone realizing it?

Meet Hemina Harris, ARNP, a nurse practitioner specializing in general otolaryngology and pediatrics at the University of Iowa Health Care System, adjacent to one of the country’s most established cochlear implant centers. Working on the front lines of ENT, Mina often becomes the first provider to recognize when a patient’s hearing loss may need to progress into a CI consult.

In this episode, we take a closer look at one of the biggest blind spots in cochlear implant care: the referral pathway itself. Why are so many qualified patients still slipping through the cracks? And what happens before they ever reach the cochlear implant team?

What You’ll Hear:

· The Front Door Problem: Why general otolaryngology clinics may be one of the most overlooked opportunities for identifying CI candidates

· “I Thought Hearing Aids Were My Only Option”: The education gap preventing patients from exploring cochlear implants sooner

· The 60/60 Referral Rule: A simple screening framework that can help providers recognize potential CI candidates faster

· Workflow Bottlenecks: How imaging, insurance approvals, scheduling delays, and fragmented communication slow patient access

· The Mid-Level Perspective: Why nurse practitioners and physician assistants are uniquely positioned to improve CI identification and coordination

· Referral Confidence Matters: How seeing successful patient outcomes encourages more providers to refer candidates earlier

· The Communication Disconnect: Why providers inside the same department often never hear what happened after a referral is made

· Building Better Systems: How multidisciplinary teams can improve coordination and reduce the risk of patients getting lost in the process

Mina offers a practical and honest look at what happens in real-world ENT clinics every day. From quick screening conversations to coordinating imaging before surgical consults, this episode highlights the critical role advanced practice providers play in helping patients access cochlear implant care sooner.

Who should listen?

Audiologists, otolaryngologists, neurotologists, nurse practitioners, physician assistants, primary care providers, cochlear implant coordinators, practice administrators, and anyone involved in hearing healthcare delivery.

If you’ve ever wondered where cochlear implant candidates are getting lost before they even make it to the CI team, this conversation shines a light on the gaps and the opportunities to fix them.

Stay up to date with us: LinkedIn, Facebook, and Instagram @MedAudPro

Want to learn more about FCOM?
https://FCOMnow.com

Join the MedAudPro Provider Community for free access to behind-the-password content and connect with providers practicing at the top of their game:
https://medaudpro.com/register

This episode is sponsored by Envoy Medical.

She's back! Meet Dr. Camille Dunn, PhD, cochlear implant expert, industry leader, and the co-host who helped make our 2023 CI series a success. In this intro episode, Susan and Camille reunite to set the stage for what's changed (and what hasn't) in cochlear implant care since 2023.

What You'll Hear:

• The State of CI in 2026: From ACIA's updated candidacy recommendations to Medicare's expanded criteria and FDA approvals opening doors for new populations, what progress has been made and where are we still stuck?
• Workflow Evolution: Why two-day activations became single-day, and why being open-minded about change is critical for providers today
• Referral Bottlenecks & Capacity Strain: The real barriers keeping 95% of eligible patients from getting implanted
• Telehealth, AI & Trimming Unnecessary Visits: How modern CI programs are rethinking post-operative care
• Breaking Down Silos: Why cochlear implants are no longer just for specialists - general practice audiologists need to be in the loop
• ICIT Partnership Announcement: Learn about the exciting pre-conference hands-on CI training coming to FCOM in November 2026 at the Grand Floridian (Nov 12-15).

Camille brings her experience as Associate Professor and Director of the Iowa Cochlear Implant Clinical Research Center, plus her role co-authoring the landmark ACIA Task Force recommendations for adult CI candidacy. Over the next 12 episodes, she and Susan will tackle the biggest questions in CI care with surgeons, audiologists, researchers, and innovators driving the field forward.

Who should listen? Audiologists (CI specialists AND general practice), otolaryngologists, nurse practitioners, physician assistants, speech-language pathologists, and anyone working in or around hearing healthcare.

This isn't just about staying current—it's about understanding how CI candidacy has fundamentally shifted, and what that means for the patients sitting in front of you today.

Stay up to date with us: LinkedIn, Facebook, and Instagram @MedAudPro

Want to learn more about FCOM? https://FCOMnow.com

Join the MedAudPro Provider Community for free access to behind-the-password content and connect with providers practicing at the top of their game: https://medaudpro.com/register

This episode is sponsored by Envoy Medical.

What's really driving cochlear implant growth in 2026? And what's holding it back? Meet Dr. Dan Zeitler, MD, FACS, Chair of the American Cochlear Implant Alliance (ACIA) and co-director of the Listen for Life Cochlear Implant Center in Seattle. As the lead author on ACIA's groundbreaking task force recommendations for adult CI candidacy, Dan has a front-row seat to the market forces reshaping the field.

What You'll Hear:

·      The Penetration Problem: Why only 2% of eligible candidates are getting implanted under expanded criteria (down from 12-13% under traditional Medicare standards)

·      The Numerator vs. Denominator Challenge: More people are being implanted than ever before, but the pool of eligible candidates is growing even faster

·      Who's Coming Through the Door (and Who Isn't): Why single-sided deafness and asymmetric hearing loss patients are flowing in, but bilateral hearing loss patients remain resistant

·      Supply vs. Demand: Is the bigger bottleneck lack of patient awareness or lack of clinical capacity?

·      The Primary Care Gap: Why PCPs are the critical missing link in the referral pathway

·      Workflow Revolution: How reducing appointment schedules, adopting remote programming, and partnering with community audiologists can scale CI access

·      The 40-Year Problem: Why the field must be willing to change workflows that have been standard practice for decades

Dan doesn't pull punches: "We all have to be willing to change what we've done with our patients for the last 40 years. We have to be willing to change." This conversation tackles Medicare expansion, private payer follow-through, competitive dynamics among the three major manufacturers, and the workforce capacity constraints threatening to create a supply-side crisis.

Who should listen?Audiologists, otolaryngologists, neurotologists, program directors, hospital administrators, payers, policymakers, and anyone trying to understand why 95% of eligible CI candidates still aren't getting implanted.
If you're wondering whether the field is actually ready for the demand that expanded candidacy could create, this episode gives you the honest answer.

Stay up to date with us: LinkedIn, Facebook, and Instagram @MedAudPro

Want to learn more about FCOM? https://FCOMnow.com

Join the MedAudPro Provider Community for free access to behind-the-password content and connect with providers practicing at the top of their game: https://medaudpro.com/register

This episode is sponsored by Envoy Medical.

Kicking off this short-format series on Patient Engagement, Jamie Benson, the CEO of QM2 Solutions sets up the landscape of patient engagement looks like in 2023.

Stay up to date with us on LinkedIn, Facebook, Twitter and Instagram @MedAudPro.

Joining the MedAudPro Provider Community is a great way to support our show, get free access to behind the password content and interact with other providers looking to practice at the top of their game. Subscribe today at bit.ly/JoinMedAudPro

This episode is sponsored by QM2 Solutions.

Wrapping up this sprint series on CI, Brent Lucas, the CEO of Envoy Medical helps recap the episodes.

Stay up to date with us on LinkedIn, Facebook, Twitter and Instagram @MedAudPro.

Joining the MedAudPro Provider Community is a great way to support our show, get free access to behind the password content and interact with other providers looking to practice at the top of their game. Subscribe today at bit.ly/JoinMedAudPro

This episode is sponsored by Envoy Medical.

Ray Gamble, the MED-EL President of North America.  He talks history, innovation, and how the company is committed to focusing on the individual. Be sure to listen in, and enjoy the in-depth overview of tech and provider insights.

Stay up to date with us on LinkedIn, Facebook, Twitter and Instagram @MedAudPro.

Joining the MedAudPro Provider Community is a great way to support our show, get free access to behind the password content and interact with other providers looking to practice at the top of their game. Subscribe today at bit.ly/JoinMedAudPro

This episode is sponsored by Envoy Medical.

Cochlear America's President, Lisa Aubert, shares her journey, the company's mission, and how it impacts the direction for the future.  Wondering where the Industry leader is heading? This episode is for you.

Stay up to date with us on LinkedIn, Facebook, Twitter and Instagram @MedAudPro.

Joining the MedAudPro Provider Community is a great way to support our show, get free access to behind the password content and interact with other providers looking to practice at the top of their game. Subscribe today at bit.ly/JoinMedAudPro

This episode is sponsored by Envoy Medical.