Sam Shear, Yes Hearing, on innovating & scaling a novel model of at-home hearing health

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Sam Shear, CEO of Yes Hearing

In this episode, I sat down with Sam Shear, CEO of Yes Hearing. Founded in 2019, Yes Hearing is an online provider of hearing care and hearing aids, partnering with 400+ audiology providers to provide in-home services such as phone and video consultations, hearing tests, hearing aid fitting, programming, and follow-up care. Through their unique model, Audiologists and hearing specialists bring the clinic directly to patients’ living rooms; the company is now the largest in-home hearing care provider in the world. The company was founded in 2019, and secured its $10M Series A funding in 2022.

Sam and I discussed:

• Yes Hearing’s background and mission, including personal family anecdotes that led him to start the company
• The company’s clinical model, go-to-market strategy, patient journey, and dedication to iterative feedback & improvement
• Trends in the broader hearing care and at-home care industries, including both tailwinds and barriers to patient adoption
• Entrepreneurial advice relating to fundraising with investors, scaling with payers, and believing in the potential of an early-stage company!

Beginning–6:13: Sam’s background and path to starting Yes Hearing

• Early Years: Sam grew up in London, which may be initially striking given that he entered the U.S. hearing care market. He always had a fascination with the U.S. market through his travels, and studied geography and economics in university, exploring content related to the aging population. Sam developed an interest in startups, and worked at a social recommendation startup straight out of college started by a friend of his. He also worked on the Sales & Marketing teams at Houzz in the UK during the company’s expansion.
• Personal Influence: Sam’s entry into hearing was unexpected, around the time that his grandmother fell ill with dementia. He started thinking more deeply about the disease and how debilitating it could be, not just for his grandmother, but for his entire family, including his parents and grandfather. Not only did Sam draw a link back to his studies around aging, but he also began to more deeply explore connectivity of hearing with dementia, and learned that hearing loss and dementia are directly correlated. Sam would visit his grandmother in her nursing home, and remembers playing music for her to trigger memories, only to realize that his grandmother required a hearing aid to listen to it. He began thinking about the many ways that a hearing aid could improve one’s quality of life, whether struggling with dementia or not. Sam’s co-founder, Oliver, also had a grandmother who struggled with dementia, facing similar challenges.
• From UK to US Market: Sam drew upon what he learned in college and his experiences traveling to the US, but realized that the UK market was far ahead of the US from a hearing care standpoint. Many entrepreneurs in the UK start a business with the ultimate goal of expanding to the US, but Sam figured he might as well enter the US market directly to fill a market gap and truly make a systematic impact on the healthcare system.
• Deciding on an At-Home Model: Yes Hearing’s decision to enter the at-home health model was based on both 1) an increasing industry shift towards at-home healthcare post-pandemic, and 2) observation of another UK startup that had successfully offered at-home healthcare services.

Several core pain points in the hearing industry led Sam to develop the business:

• Retail Environment: Traditionally, individuals buy a hearing aid through either a large retailer or a single store location, many of which have non-transparent pricing and limited product selection.
• Stigmatization: Moreover, there is a huge stigma behind hearing loss, which poses a barrier to addressing the condition even before a patient even enters a store — most patients wait up to 7 years before addressing their hearing loss.
• Fragmented Market: To Sam, the hearing market appeared two-fold: patients either 1) saw excellent products and care provision at the clinic level, but with prohibitive cost of access, or 2) purchased products online at a lower price, but with very limited care, resulting in not using the hearing aids they purchase.

6:14–16:12: Company Overview

Yes Hearing combines the best of both of these two fragmented market alternatives, creating a new model of purchasing a hearing aid through a novel distribution channel, and following up with at-home care. The company serves as the bridge between the online-only e-commerce model and the clinic model, while bringing services into the home.

I spoke with Sam about the patient journey, and learned how personalized the journey is from end-to-end, from initial website visit through care provision:

• E-Commerce Website: Patients click onto the website, Yeshearing.com, where they can explore the model and conduct a full lifecycle assessment, enabling selection of the best hearing aid for a specific individual.
• Patient Consultation: Patients receive a full consultation, either through phone or video call, with one of Yes Hearing’s specialists from a call center.
• Home Visit: One of 400 audiologists/hearing specialists across the country visits the patient’s home and conducts a full hearing assessment, including hearing aid fitting and programming, background noise testing, speech testing, and more. In addition to interacting with the patient, the audiologist speaks to surrounding family members and caregivers to learn additional information.
• Follow-Up Care: Patients are left with a preliminary hearing aid after the first visit, and are instructed to adjust to the new sound over the course of about two weeks, as it often takes time for the brain to adapt to the novel sensory experience. After two weeks, the team returns to the home, and makes any necessary adjustments.

While the hearing market as a whole is quite commodified, as many hearing aid products appear similar at the top-, mid-, and basic-levels, the right hearing aid can be selected based on features that match a patient’s lifestyle. The process requires trial and error, and Yes Hearing takes care to understand a patient’s individual needs upfront so that it can provide the right hearing aid for the right patient, taking into account:

• Daily activity
• Occupational status and location
• Family / friend interaction (frequency, type)
• Leisure type & frequency (e.g., travel, watching TV, theater)
• Rechargeability requirements

Primary patients of Yes Hearing tend to be from a younger demographic, with an average age of 66, significantly lower than the average age of a hearing aid adopter (71–72). The company aims to reduce the 7 year gap from when a patient becomes aware of their hearing loss to when they decide to take action to address it — the ease of accessing Yes Hearing’s website and virtual care leads to more patients taking action more quickly than they might otherwise. Supporting patients who require hands-on guidance, and who may have tried another option unsuccessfully, is of utmost importance to Sam and his team.

Company differentiation is primarily a result of Yes Hearing occupying its niche as the only in-home hearing company at scale. In-home hearing care is unique, difficult to replicate, and benefits from the independent model Yes Hearing provides, which is very rare in the industry (most vendors, distributors and manufacturers are vertically integrated). Because the company does not benefit from recommending one product over another, patients can trust Yes Hearing to deliver unbiased, top-quality care in a personalized manner.

16:13–23:13: Growth Opportunities for Yes Hearing

Several industry shifts present opportunities for Yes Hearing to gain traction:

• Increasing Awareness as a result of OTC Hearing Aids: According to Sam, the introduction of over-the-counter (OTC) hearing aids has arguably been the most exciting change in the hearing industry in over 50 years, opening up a whole new world of awareness across patients and the general population. Hearing loss as a topic is becoming more commonplace and less stigmatized. However, many patients who think they are a fit for OTC may try it out and realize it doesn’t work for them as a lasting solution. Rather than watching those patients drop out of the market, or delay another five years before taking action to improve their hearing, Yes Hearing aims to swoop in and provide care at this critical juncture. The company has the unique opportunity to partner with OTC vendors and release marketing content to explain that if OTC fails to serve a patient’s needs (e.g., sound threshold too low, ill fitting), it can step in to provide a prescription hearing aid at a more advanced level.

“There’s definitely confusion in the market about OTC hearing aids. So what we’re trying to do is bridge that confusion, break through the noise and really give people good advice. But the effects are still so early that we’re going to have to wait and see.”

• Expansion of At-Home Care: Sam and his team quickly realized several major benefits to the at-home model. Audiologists, the majority of whom work part time, desire more flexible work arrangements— this model enables them to provide high-quality care and make an impact on patients while maintaining more flexible hours. Additionally, audiologists who were displaced from work during the COVID-19 pandemic when clinics were closed were able to continue providing care for patients sheltered at home. Moreover, patients who may not be suited to either the clinic or to the OTC market are able to receive care in a tailored manner.
• Partnership Opportunities: As payers begin to adopt at-home healthcare at higher rates, a unique opportunity exists to secure payer partnership, especially since benefits of the program extend beyond hearing care and towards other forms of screening (e.g., patient fall risk) and intervention. Moreover, as consolidation occurs across the healthcare industry, opportunity also exists to partner with other vendors of at-home care, primary care physicians, opticians, and more; Partnerships will be a big part of the company’s strategy moving forward.
• Incorporating Behavioral Health & Social Determinants of Health: Hearing is only one part of the full picture, as the company’s at-home model provides Audiologists the privileged position of observing health dimensions in the home beyond a patient’s hearing. Audiologists can screen for things like behavioral health conditions, fall risk (especially in older adults), balance testing, nutrition, fitness, etc., and can explore conditions within the home such as lighting, fall hazards, access to technology and other essential needs that fall under social determinants of health. Yes Hearing’s clinicians can then refer patients to a primary care physician or to another company in their area of need to get the patients access to the proper health or care.
• Raising Awareness about the Inner Ear: The inner ear is not only a center of hearing, but also a center of balance, which is often overlooked. Hearing dictates how the human brain functions, including the ability to process sound, process information, communicate, empathize, and engage with others. Yes Hearing not only provides the hearing aid and supports the patient to ensure use of the hearing aid, but also takes on a broader role within the care ecosystem, serving as a caregiver across multiple dimensions.
• Securing Payer Coverage: To make the solution more accessible to patients, the Yes Hearing team has been focused on attending conferences to learn more about Medicare Advantage and Medicaid programs and the compliance requirements / metrics (e.g., MA Star ratings), with the ultimate goal of pitching to health plans and securing payer coverage. Stressing Yes Hearing’s unique value proposition as the first of its kind at-home audiology company, as well as the fact that the company can provide holistic benefits to at-risk members beyond hearing care and utilization of hearing benefits (e.g., decreased costs due to at-risk member referrals, fall risk prevention), will help make the case to payers.

23:14–26:52: Audiologist Recruiting & Training

Sam explained that the Yes Hearing team began recruiting audiologists back in 2019 in New York City and Long Island, after which word of mouth grew rapidly. Through the help of an internal recruiter, the team sourced many more clinicians, who were attracted by the flexible work model and patient care value proposition.

Audiologists receive continuous training extending beyond hearing care, including:

• Soft skills such as bedside manner, communication, patient experience — after all, these audiologists are entering a patient’s home into what is often a very intimate experience, and have the chance to make a patient impact beyond hearing care, requiring a set of skills above that which would be required in clinic.
• Technological competence, as audiologists must perform remote assessments with remote audiology kits and connected equipment.
• Cultural competence and DEI, especially since audiologists learn a lot of sensitive patient information from the moment a patient engages in a preliminary assessment via phone. Yes Hearing’s Patient Coordination and Customer Service teams gather information prior to the first visit, and if they notice a cultural barrier or patient concern, these teams pass information off to the provider ahead of the patient visit. The company also ensures they are hiring bilingual clinicians and those from diverse backgrounds.
• Encouraging family involvement, as the hearing aid is only part of the picture — patients who are supported by their family members and surrounding ecosystem are often more motivated to improve their overall care, including both adhering to wearing their hearing aid and caring for their broader health. Especially for the elderly, who may face difficulty connecting with solutions in a technology-driven environment, family involvement can be critical to adherence.

26:53–31:07: Barriers to Patient Adoption

Sam and I discussed some of the critical barriers towards patient adoption of hearing aids and broader hearing care, including:

• Cost: Hearing aids are very expensive, ranging from $1K-5K within the realm of Yes Hearing’s offerings (and potentially reaching $10K-12K in a clinic context. Price disparity generates additional confusion for patients already overwhelmed by a multitude of options on the market. Sam and his team work with finance vendors to make the pricing as transparent and accessible as possible.
• Stigma: Despite the prevalence of hearing loss and the introduction of OTC hearing aids, patients of all ages suffer from stigma and feel ashamed of their hearing loss, and as a result neglect to seek or adhere to care.
• Emotional Barrier: Once patients get over access barriers, both in terms of cost and choice overload of options, many still face the emotional barrier of committing to take action to improve their hearing, even when it may seem logical to seek care.

Moving into 2023 and beyond, Sam predicts that volume and patient will increase with the continued rise of over the counter hearing aids, online presence of hearing aids, and at-home care provision.

31:08–36:02: Sam’s Entrepreneurial Journey and Path to Fundraise

Sam and I spoke about his path to securing a Series A fundraise, from the time he met his first investors, including Abby Levy from Primetime Partners, who took a keen interest in what they were building. Investors set a series of milestones for the team to achieve over the next year before investment, which they were able to reach in a matter of months. The Yes Hearing team quickly proved their solid foundation and strong business model, ultimately securing their first investor.

Investors resonated overall with the strong storyline of the company, including the obvious product-market fit, and many were generally surprised this model had not yet been established! Moreover, the technology-driven nature of the business, along with industry tailwinds (e.g., population aging, OTC hearing aids) pointed to a winning business. The company has also secured investment from Blue Heron Capital, which has lent Sam and his team a group of advisors to help grow, scale, and make impact.

I also asked Sam about surprises he faced when starting the business, to which he replied “you never know until you do it,” a theme often echoed by entrepreneurs taking a bet on an industry.

“A lot of the time, you’re making a bet on a logical assumption that just makes sense, and you’d be amazed how many times your logical approach [as a founder] just doesn’t work out the way you think it will…that was one of the biggest surprises. When we first started, I fell into the same trap that most people do, which is a failure to really launch — you always seek perfection. And I think gradually you erode that away and say, ‘you know what, doing something is always better than doing nothing. Let’s get this [concept] to a really good place, build the foundation, move on, and then go and fix.’”

This iterative cycle of listening to the customer is a process Yes Hearing adheres closely to. The company sends out surveys via email to keep a pulse on customer feedback, but also gathers in-person feedback during home visits. The company is so committed to building a rapport with each patient that if a patient cancels their order or returns a hearing aid, Sam and his co-founders personally get on the phone with them to help address any issues. This is how Yes Hearing maintains a constant feedback cycle with the customer and illuminates areas for iterative improvement. Considering that the team is only 32 employees at the moment (excluding part-time contractors), this dedication to feedback and improvement reflects a strong team with a massive degree of agility.

36:03 — End: Closing Remarks

Looking ahead, Sam’s goal for Yes hearing is to be “the ultimate hearing provider,” combining access to hearing aid products with clinical care to become the world’s best provider of holistic hearing care. He also shared his bolder vision for the future:

“If I look really long term, I think, can we do more for healthcare in the home? Is there a way we can provide other services connected with our hearing that are going to actually help the same group of patients and customers that we currently work with? What excites me is, if we can prove [this model] in hearing, we can do so much more. But proving it within hearing itself is a massive undertaking, and will be an incredible achievement if we can get that far.”

In closing, Sam shared some advice for our entrepreneurial listeners:

• “Always strive to learn, and know that you’re not always the smartest person in the room.” The beginning of launching a company as an early-stage founder requires playing an active role in every facet of the business. While this is important to embrace, as the company scales and hires new talent, it’s also critical for an entrepreneur to let new employees guide you.
• “Be prepared to fail.” The business will likely take constant twists and turns!
• “Maintain a strong support network.” There will be difficult moments faced as an early-stage founder. Asking for help from a support system makes these moments easier.

We are very appreciative to Sam for joining us on this episode of The Pulse Podcast! Subscribe for our new releases on Twitter, Spotify or Apple podcasts.