Dental Trends 2017 IPMA Conference June 5th, 2017
Todays Conversation, Changing Landscape of Dental Dentistry Through the Ages Changes in the Dental Practice Group & Individual Dental Markets Oral Health & General Health Group Dental Reporting Analyzing member Behaviors
About Delta Dental Delta Dental Plans Association 39 Delta Dental Member Companies 90,000,000 Dental claims annually (2013) 99.8% Financial accuracy 70 Million Members Nationwide 114,000 Groups across the nation
Improving Health through Oral Health
Dentistry through the Ages - Milestones 5000 BC Sumerian s describe Tooth Worms as cause for dental decay 1500 BC Egyptians Refer to Diseases of Teeth and various remedies 1790 George Washington s Dentist built a Dental Foot Engine 1825 Samuel Stockton begins commercial Mfg. of Porcelain Teeth 1841 Alabama Enacts the first Dental practice Act 1895 First Dental X-Ray used New Orleans 1911 US Army Dental Corps established 1945 Water Fluoridation Begins 1962 Composite Resin Restorative material introduced 1990 Esthetic Dentistry Increased use of Bleaching, Veneers, and implants
Dental Practice Trends Growth of Large Practice s Advances in Technology Diagnostic Tools Implants Home Health Care Advancements Medical Dental Connections Science Based Healthy Outcomes ACO Plans Emphasis on Prevention Changes in Workforce Tele-Dentistry Dental Therapist - MN First State to license
Group Dental Delivery Employers still maintaining group coverage Public / Private Exchange Options Models Enrollment Platform Carrier Choice (some) Employee Plan Choice
National Dental Plan Enrollment
Employers Providing Dental Benefits
Dental Plans Dental Enrollment 64% of US Population From 61% in 2013 PPO plans continued growth to 82% 100% employer Paid 6.5% from 20% 5 years ago Voluntary 23.5% from 10.3% 5 years ago Stacked & Leased Networks
Financial & Plan Trends Interest in Higher Annual Maximums Growth of Self Insured Arrangements Carrier PPO Average Trend Nationally 4.63% in 2016 Excluding Diagnostic & Preventive Services from Annual Maximum Adult Orthodontic Benefits Longer Guarantees for Fully Insured Plans
Benefit Design by Size of Group Annual Deductible 1-199 Employees 200-499 Employees 500-999 Employees 1000-4999 Employees None 15% 10% 12% 13% $25 37% 35% 36% 32% $50 45% 51% 48% 50% Annual Maximum $1,000 44% 32% 31% 23% $1,500 27% 37% 38% 41% $2,000 15% 17% 15% 19% Lifetime Orthodontia No Ortho 40% 25% 30% 20% $1,000 35% 36% 29% 18% $1,500 15% 23% 26% 32% $2,000 6% 8% 8% 16%
Consumer Trends Consumers with Dental Plan Twice as likely to visit the dentist Managing Increasing Costs Growth of Individual plans
Growth of Individual Dental Rise in Consumerism Web based purchasing access Increase in Carrier Focus 10,000 Boomers turning 65 each day Individual Dental 2011 2.4% Market Share of Commercial Dental 2014 7% Market Share of Commercial Dental» Growth started prior to ACA Individual Mandate
Pediatric Dental and the ACA One of Ten Essential Benefits Individual and insured medical Small Groups under 50 Qualified Health Plan Requirement Medical plan Reasonable Assurance Requirement Satisfied by embedding, Stand-Alone, Attestation or Notification Pediatric Dental Requirements are managed on a State Level Embedded Pediatric Dental is different from stand alone MN Medical carriers are either embedding Pediatric dental or notifying members it is not included.
State of Oral Health Dental Carries - # 1 Preventable chronic disease condition in Children Untreated tooth decay: 2 out of every 10 Minnesota third graders in public schools have untreated tooth decay 1. Total permanent tooth loss: 10.5 percent of Minnesota adults ages 65 and older are missing all their natural, permanent teeth due to tooth decay or gum disease 2. Any permanent tooth loss: 35.6 percent of Minnesota adults ages 65 and older are missing at least one natural, permanent tooth due to tooth decay or gum disease 2
Oral Health - General Health Links
>120 medical conditions can be detected by signs and symptoms in your mouth
Diabetes & Oral Health Having Diabetes Can Promote Periodontal Disease Oral Disease more severe with Diabetics Diminished Salivary Flow Leads to Higher Incidence of Tooth Decay Increased Risk of Gum Recession
Stress & Oral Health Your Teeth know if you are stressed! Bruxism Teeth Grinding Temporomandibular (TMD) Gum Disease Canker Sores
Your Heart & Oral Health People with gum (periodontal) disease are more likely to have heart disease than those with healthy gums. Gum disease (called gingivitis in its early stages and periodontal disease in the late stages) is caused by plaque buildup along and below the gum line. Bacteria from infected gums can dislodge, enter the bloodstream, attach to blood vessels and increase clot formations.
Your Kidneys & Oral Health If you have Kidney disease, you need to take extra care of your teeth People with Kidney disease may develop bad breath Metabolic problem that produces chemicals Chemicals are exhaled through the lungs Brush the tongue, odor causing bacteria located at back of tongue
Pregnancy & Oral Health Many will experience some Oral Health Changes During Pregnancy Changes are due to a surge in hormones Estrogen and Progesterone Causes Gum Tissue to exaggerate Reaction to plaque Can eventually harden into tarter and increase Risk of Gingivitis Pregnancy may worsen gum conditions and can lead to periodontitis Excessive bacteria can enter the blood stream through your gums Inconclusive research on Pre term / Low Birth Weight babies
Lungs & Oral Health 20 Million Americans have Asthma Medications contribute to: Dry Mouth Increased Cavities Bad Breath Gum Problems
Cancer & Oral Health 6 th most Common Cancer 30,000 cases diagnosed each Year Accounts for 8,000 deaths Early detection increases survival rate Importance of Twice Yearly Check ups
Barriers to Dental Care Cost No Dental Plan Deductibles & Coinsurance Fear & Anxiety Convenience - Mobility
Analytic Reporting - Healthentic Dental Action Report (DAR) Healthentic is a reporting tool that explores member s behaviors and the effect those behaviors have on claims. Gives employer groups another way to see the dental plan utilization of their employees and families and provide valuable directions to improve health. Behavior is tracked providing easy to understand actionable numeric values.
The Dental Action Report Places Members Into Four Risk Categories Healthy - These members had preventive care only. Moderate - These members primarily had preventive care and treatment. Serious - These members had emergency care only or extensive care. No Visits - These members had no dental claims.
Former Surgeon General C. Everett Koop You re not healthy without good oral health
Thank You!