The evidence connecting dental health with overall health has been mounting, a fact acknowledged in the Affordable Care Act when pediatric dental coverage was considered an essential health benefit. A study from UnitedHealthcare connects the dots even further to show that attention to oral health can have a tangible impact on overall health costs.
Research from the Medical Dental Integration Study in March shows people with chronic conditions who received appropriate dental care had net medical and dental claims that were, on average, $1,038 lower per year than the claims of chronically ill who did not receive such oral care.
Even more “good news” from the study, according to Dr. Michael Weitzner, vice president, UnitedHealthcare Dental, is the fact that savings were still significant for people who received regular dental care but were not compliant with their chronic condition care. According to the study, based on dental claims from 2008 to 2011, annual average medical costs were $2,320 lower among the group receiving dental care than those not receiving it. Even after accounting for the cost of dental care, net savings were $1,829.
“We were wondering about dental engagement, if it’s a factor or if it’s people engaging in good behaviors anyway,” he says. “The study showed that dental care as an independent factor was very important in maintaining health.”
Weitzner appreciates that the ACA “has really focused people’s attention” on the importance of dental being part of overall health care for children, but acknowledges “there’s a little less attention” on the integration for adults. Even so, says Jolynne Williamson, assistant vice president, group dental products at The Guardian Life Insurance Company of America, “it’s certainly brought attention to the importance of oral health care — the fact that the government felt strong enough to include it in a set of essential medical benefits … is very telling.”
Williamson points out that the pediatric dental health benefits portion of the ACA is the only one that can be covered by a standalone plan, rather than be included with the medical plan. As a result, “we’re seeing employers really explore all ... options,” she says. Such options include embedding pediatric dental coverage in a medical plan or overlaying a standard plan with pediatric dental requirements so “that employers can make sure they’re compliant,” Williamson says.
All of the change in the dental industry is “causing a fair bit of confusion for employers and advisers, even some of the medical and dental insurance carriers,” says Amy Friedrich, vice president, Special Benefits Division with Principal Financial Group. It’s not necessarily a good or bad thing that an employer’s pediatric dental might look different from adult, “it’s just something that was a point of clarification ... that didn’t really exist before,” she says.
It’s important now, says Friedrich, to ensure people know their network and how their claims will be handled. Additionally, multi-state employers must consider that each state approached the ACA’s pediatric requirements differently. “These things are all workable,” says Friedrich, “but there is a fair bit of flux right now in the dental insurance industry. I think that flux could be exciting because it’s an industry that hasn’t seen a whole lot of change.”
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