Is there a way to start speaking a word using macOS text to speech by hovering over it and pressing a shortcut?
You can use the following Keyboard Maestro macro:


Add a double click at current mouse location action.
Add a press ⌥⎋ action.
⌥⎋ the default shortcut for ‘Speak selected text’, set in System Preferences → Accessibility → Speech. Change this to match the preference at that location.
Set the macro to be triggered on a hot key.