Author Robin Hobb wrote “One must plan for the future and anticipate the future without fearing the future.” At the recent 2014 Converge Session of the National Association of Dental Plans a few trends emerged that help us to plan for the shifting dental benefit landscape.
Dental industry watchers have always taken note of changes in medical plan design and now must include observations on the impact of Affordable Care Act (ACA) plans.
The keynote address – provided by Caroline Pearson, Vice President of Avalere Health – kept us repeating the words “we don’t know.” This is in response to questions that we all have: what will dental benefits look like in ten years? Will the ACA be repealed? Will employers move away from stand-alone dental plans? The response to all of these and more is quite frankly “we don’t know.” Ms. Pearson did a great job discussing the ways employers will seek to keep dental plan costs low.
Other themes included network improvement and analytics. The use of narrow networks has taken hold on the medical side of health care and we are starting to see their increased usage in dentistry. Narrow networks refer to the utilization of smaller panels of providers in an effort to reduce cost. Many of these plans that utilize narrow networks do not provide benefits outside of the network providers.
Data collection and analysis companies were well represented on the exhibit floor. Companies seek to not only control costs but to identify providers that abuse coding practices. The ability to identify outlier patterns is helped by the increased communication of patient data via electronic health records (EHR).
EHR, as well as the Affordable Care Act, is moving our healthcare system toward more structured data. A standard EHR and interoperable national health information infrastructure requires the use of uniform health information standards, including a common language. Data must be collected and maintained in a standardized format, using uniform definitions, in order to link data within an EHR system or share health information among systems.
The conference concluded with a panel discussion on the future of dental benefits. The outlook was cautiously optimistic that employers would continue to provide dental benefits to our patients. The challenge will be to keep these benefits affordable for both the purchaser and the employee.
Editor's note: We caught up with Teresa Duncan at the ADA Annual Session in San Antonio and asked her about what was coming in insurance and what dental professionals needed to know. See our exclusive video interview below...
Patti DiGangi, RDH, BS, is a clinician, speaker, author and coach. She is an ADA Evidence Based Champion and holds a publishing license with the American Dental Association for Current Dental Terminology. She is the author of the DentalCodeology series of mini-books. She was awarded the 2014 Sunstar Award of Distinction, 2014 CE Leaders Recognition and 2013 Sonicare Mentor of Distinction.
Teresa Duncan, MS, FADIA, FAADOM, is an international speaker who focuses on revenue & management issues. She is a Fellow of the American Assn of Dental Office Managers. Her memberships include the American Academy of Dental Consultants, National Speakers Association and the Academy of Dental Management Consultants. She was recently named one of the Top 25 Women in Dentistry. Teresa received her Master’s Degree in Healthcare Management.