Request for Information: Hearing Healthcare for Adults: Improving Access and Affordability
Notice Number:

Key Dates

Release Date:

June 3, 2024

Response Date:
August 14, 2024

Related Announcements


Issued by

National Institute on Deafness and Other Communication Disorders (NIDCD)


This Request for Information (RFI) invites input from all interested parties (individuals or groups) on NIDCD’s future research directions toward improving the accessibility and affordability of adult hearing health care. Issues affecting access and affordability are wide-ranging and include those factors that drive uptake and equity. The mission of the NIDCD is to advance the science of communication to improve lives.


NIDCD is the lead federal agency promoting the Nation’s hearing health care. The institute supports basic and translational research into the normal and disordered processes of hearing and communication disorders, as well as science focused on the care and rehabilitation of persons of all ages with hearing loss. This includes our work to systematically explore and prioritize hearing health care access and affordability.   

For many reasons, the current hearing health care system in the United States is not meeting the needs of many adults with hearing loss. In 2009, NIDCD sponsored a working group on Accessible and Affordable Hearing Health Care for Adults with Mild to Moderate Hearing Lossthe purpose of which was to develop a research agenda to increase access and affordability of hearing health care, including accessible and low cost hearing aids. A series of recommendations were generated and prioritized based on both importance and immediate feasibility. This activity launched a concerted effort for the institute to promote, support, and prioritize research that would address these needs and has been a driver of important changes in the hearing health care landscape.

As part of the institute’s investment, NIDCD along with several federal and advocacy partners, supported a National Academies of Sciences Engineering and Medicine consensus study on adult hearing health care in 2016 with an emphasis on access and affordability. The resulting report recommended a series of key institutional, technological, and regulatory changes that prioritize the needs of individuals with hearing loss. The President’s Council of Advisors on Science and Technology (PCAST) took up the issue of adult hearing health care, recognizing that untreated hearing loss, particularly in older Americans, “?is a substantial national problem.” PCAST also generated a series of recommendations that the Federal Government could immediately take to open the hearing aid market, lower hearing health care costs, and promote innovation.

Of the sweeping recommendations generated across the 2009 NIDCD working group, the 2015 PCAST report, and the 2016 NASEM consensus study, the call for a lower cost, direct-to-consumer hearing aid service delivery model was unanimous. NIDCD funded studies exploring the viability of this option that demonstrated an over-the-counter model of hearing aid distribution could be safe and effective. In 2017, bipartisan legislation was passed compelling the Food and Drug Administration to develop a first-of-its-kind category of over-the-counter (OTC) hearing aids available directly to adults with perceived mild to moderate hearing loss without requiring the assistance of a professional. In October 2022, the OTC hearing aid rule was finalized and put into practice.

Much has been accomplished to shift focus to and make headway on issues of access and affordability in adult hearing health care. Nonetheless, many opportunities for progress remain, and many new questions have been generated with changes in policy and care delivery. Continued collaborations and an intentional focus on actionable research priorities remain necessary.

60-day Comment Period:

Comments must be received no later than August 14, 2024

Information Requested:

Further research is needed to strengthen the evidence base with a goal of delivering better hearing health care outcomes in adults. NIDCD welcomes thoughts from all interested parties about the needs and opportunities to improve adult hearing health care toward a determined and ideal outcome(s), with an emphasis on access and affordability, and seeks comments across a wide range of issues, from improvements in technology to innovations in service delivery, and those factors that drive timely uptake and equity.

How to Submit a Response:

All responses to this RFI must be submitted via email to by August 14, 2024.  Please include the Notice number in the subject line of your response.  Responses to this RFI are voluntary and may be submitted anonymously. You may voluntarily include your name and contact information with your response. If you choose to provide NIH with this information, NIH will not share your name or contact information outside NIH unless required by law.

Other than your name and contact information, please do not include any personally identifiable information or any information that you do not wish to make public. Proprietary, classified, confidential, or sensitive information should not be included in your response. The US Government will use the information submitted in response to this RFI at its discretion. Other than your name and contact information, the Government reserves the right to use any submitted information on public websites, in reports, in summaries of the state of the science, in any possible resultant solicitation(s), grant(s), or cooperative agreement(s), or in the development of future funding opportunity announcements. This RFI is for information and planning purposes only and is not a solicitation for applications or an obligation on the part of the Government to provide support for any ideas identified in response to it. Please note that the Government will not pay for the preparation of any information submitted or for the use of that information.

We look forward to your input and hope that you will share this RFI opportunity with your colleagues. 


Please direct all inquiries to:

Scientific/Research Contact(s)

Kelly King, Au.D, Ph.D.
NIDCD/Division of Scientific Programs
Telephone: 301-402-3458