ADA Member GPO Survey Question Title * 1. Are you an audiology practice owner or a principal partner? Yes No Question Title * 2. Do you make the hearing aid buying decisions for your audiology practice? Yes No Question Title * 3. How many practice locations do you have? Question Title * 4. How many hearing aid units does your practice dispense each month? 0-10 11-20 21-30 31-40 41-50 51-60 More than 60 How many dispensed monthly if more than 60 units? Question Title * 5. How many different brands of hearing aids do you dispense? 1 2 3 4 More than 4 Question Title * 6. Is your practice affiliated with a manufacturer (please mark all that apply)? No. My practice is not affiliated with a manufacturer in any way. I have received manufacturer financing for my practice. I recently sold my practice to a manufacturer, but still work there as an employee. I work for a manufacturer-owned retail practice. I use a manufacturer-sponsored discount program to purchase hearing aids. I receive incentive-based pricing directly from one or more manufacturers. I have a manufacturer agreement that requires me to buy a certain number or percentage of hearing aids from a specific manufacturer. Other (please specify) Question Title * 7. Please mark all hearing aid purchasing organizations, buying groups or management organizations with which you are affiliated. Alpaca Audiology American Hearing Aid Associates (AHAA) Amplified Resource Group (ARG) AuDConnex Audigy Audiology Management Group (AMG) AuDNet AuDStandard Ear Q Elite Entheos Fuel Intela-Hear Marcon One Source Hearing Pivot Hearing Unity Other (please specify) Question Title * 8. At the ADA 2016 Annual Membership Meeting, member attendees charged ADA leaders to explore the establishment or endorsement of a co-op, group purchasing organization (GPO) to leverage buying power and obtain the lowest cost of goods (including hearing aids) for ADA members and other audiologists, with a secondary goal of earning royalty revenue for ADA advocacy initiatives. ADA has diligently assessed the idea and conducted extensive research to explore opportunities. ADA has decided not to create a new GPO. However, ADA is committed to working with existing organizations to identify strategic partnerships that will benefit ADA members. Do you believe that this is this something that ADA should pursue? Yes No Why or why not? Question Title * 9. Please share the sentiment that best represents the potential impact that a GPO would have on your practice. I am satisfied with my current purchasing practices and would not change my current buying habits. I cannot change my buying habits as I have an agreement with a third party that requires me to purchase a certain number of hearing aids from a certain manufacturer each month. I am unsure. It would depend on solely on the hearing aid brands and pricing being offered. I would be willing to consider changing my current buying habits to help benefit ADA advocacy initiatives. I am interested in exploring opportunities to change my current purchasing practices in favor of an ADA-affiliated GPO. I am ready to commit to use an ADA-affiliated GPO if one is identified, even if it means changing my current purchasing practices. Question Title * 10. What type of per-unit pricing for premium-level hearing aids would you require in order to commit to a particular GPO or buying group (please enter US dollar per unit price)? Question Title * 11. If you could receive this price per unit, how many units would you commit to purchase on a monthly basis? Question Title * 12. Please share any additional comments that you would like ADA leaders to consider in exploring GPO opportunities for members. Done