Monday, November 17, 2014

Why This Matters to Me Part 3: Reducing Costs by Controlling Periodontal Disease

By Steve Pollock, Chief Operating Officer, DentaQuest

Chronic diseases are among the most prevalent and costly of health problems in the United States. According to the Centers for Disease Control and Prevention, about half of all adults—117 million people—have one or more chronic health conditions and the combined cost of heart disease and stroke  in 2010 was estimated to be $315.4 billion. The American Diabetes Association estimates that 25.8 million Americans are diagnosed with diabetes, and another 7 million are undiagnosed. This resulted in $245B in spending on diabetes patients in 2012 alone. Clearly, uncontrolled chronic disease puts a significant strain on how healthcare dollars are spent.

As health plans try to rein in costs, managing chronic disease has become a major focus.  It’s also why including dental benefits in your health plan offerings can have a significant impact.

What many medical professionals don’t realize is that dental professionals play a significant role in providing the care and tools that can and do help to control chronic disease. There have been a number of studies that demonstrate that when patients with periodontal disease, an extreme form of dental disease, get treated, we see significant drops in the treatment costs for other chronic conditions. The studies also indicate that patients who receive treatment for their periodontal disease are better able to control their other chronic conditions and therefore, have fewer hospital admissions. For example:

  • According to a study from Blue Cross Blue Shield, the average cost of treating diabetes was $1800 less when getting periodontal treatments over 3 years.
  • Columbia University, which looked at claims data from Aetna, found decreased costs of 9% for diabetes patients, 16% for coronary artery disease patients, and 11% for cerebrovascular disease patients who were undergoing periodontal treatments.

To address the relationship between chronic disease and oral health, DentaQuest developed the One Less Worry program to help members control their diabetes through oral care maintenance. Its goals are to:

  • Increase dental access
  • Reduce the incidence of periodontal disease
  • Promote healthy lifestyles for members
  • Provide education to the medical and dental communities to raise awareness of the connection between oral disease and diabetes
  • Integrate medical data with dental data to deliver services and maximize outcomes

We reach our members in two ways. First, we send brochures and postcards directly to members with diabetes. The brochure highlights steps they can take to live a healthier lifestyle, which includes brushing, flossing, and making an appointment to see a dentist. Six months after the initial mailing, we analyze claims data to determine which members have not been to the dentist since they received the brochure. Those members are then sent a postcard reinforcing the importance of scheduling a dental appointment. Twice per year, we compile a report that measures the success of the mailings based on the number of members seeing a dentist before and after the mailing. 

Second, we work with our insurance partners’ case managers, physicians, and community based organizations to encourage them to recommend their diabetic patients see a dentist. These two tactics together will hopefully lead to better patient outcomes.

As the margins continue to compress and insurers look for new ways to manage costs, the plans that think outside the box about unique and effective ways to manage chronic disease will be well positioned for future growth.