• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content
Dental Benefits in the 21st Century: Industry Trends and Opportunities
 

Dental Benefits in the 21st Century: Industry Trends and Opportunities

on

  • 4,011 views

 

Statistics

Views

Total Views
4,011
Views on SlideShare
4,011
Embed Views
0

Actions

Likes
0
Downloads
81
Comments
0

0 Embeds 0

No embeds

Accessibility

Categories

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    Dental Benefits in the 21st Century: Industry Trends and Opportunities Dental Benefits in the 21st Century: Industry Trends and Opportunities Presentation Transcript

    • DENTAL BENEFITS IN THE 21 st CENTURY INDUSTRY TRENDS AND OPPORTUNITIES
    • Course Goal: An Idea Merchant
      • Share information and ideas that can help you provide better solutions to your current dental clients and prospects
        • Overall Economic/Societal perspective
        • Impact on health
        • Historical overview (crystal ball)
        • Current trends
        • Market Opportunities
    • Why “Dental” Hits Home
      • Toothbrush is #1 invention Americans can’t live without*
      • Growing understanding of link to overall health
      • Makes employees more productive, loyal and happy
      • Expensive and getting more so
      • *2003 Lemelson-MIT Invention Index Survey
    • Dental Work Is Expensive…
    • …Very Expensive!
    • Adult Cleaning 1 Surface Amalgam Child’s 1 st Visit PFM Crown Denture (upper) Implant (prosthesis) Source:80 th percentile of Medicode (San Diego) How Expensive Is It?
    • Adult Cleaning 1 Surface Amalgam Child’s 1 st Visit PFM Crown Denture (upper) Implant (prosthesis) Source:80 th percentile of Medicode (San Diego) How Expensive Is It? $ 96
    • Adult Cleaning 1 Surface Amalgam Child’s 1 st Visit PFM Crown Denture (upper) Implant (prosthesis) Source:80 th percentile of Medicode (San Diego) How Expensive Is It? $ 96 $ 131
    • Adult Cleaning 1 Surface Amalgam Child’s 1 st Visit PFM Crown Denture (upper) Implant (prosthesis) Source:80 th percentile of Medicode (San Diego) How Expensive Is It? $ 319 $ 96 $ 131
    • Adult Cleaning 1 Surface Amalgam Child’s 1 st Visit PFM Crown Denture (upper) Implant (prosthesis) Source:80 th percentile of Medicode (San Diego) How Expensive Is It? $ 319 $ 96 $ 131 $1,000
    • Adult Cleaning 1 Surface Amalgam Child’s 1 st Visit PFM Crown Denture (upper) Implant (prosthesis) Source:80 th percentile of Medicode (San Diego) How Expensive Is It? $ 319 $ 96 $ 131 $1,000 $1,511
    • Adult Cleaning 1 Surface Amalgam Child’s 1 st Visit PFM Crown Denture (upper) Implant (prosthesis) Source:80 th percentile of Medicode (San Diego) How Expensive Is It? $ 96 $ 319 $1,000 $1,511 $2,524 $ 131
      • 1980 $ 13.3 billion
      • 1990 $ 31.5 billion
      • $ 56.0 billion
      • 2005 $ 85.0 billion
      • 2010 (projected) $108.9 billion
      • Source: U.S. Health Care Administration
      Dental Spending in the U.S.
    • Dental Spending in the U.S.
        • How Americans Pay
        • Private Health Insurance $27.7 billion
          • Out of Pocket Payments $25.6 billion
          • All Other $ 5.1 billion
      • Source: U.S. Health Care Administration
    •  
    •  
    • Dental Is Important To Society
      • People with dental benefits are twice as likely to go to the dentist
      • Every $1 spent on preventive dentistry saves over $4 in restorative costs
      • Poor dental health impacts every age group
      • Direct link between dental disease and major health problems
      • Source: National Institute of Health
    • Importance to Children
      • Dental caries (tooth decay) is the most common chronic childhood disease – 5 times more common than asthma and 7 times more common than hay fever
      • Over 50 percent of 5-9 year-old children have at least one cavity or filling, and 78 percent among 17 year-olds
      • 51 million lost school hours each year
      • Pain and suffering due to untreated diseases can lead to problems in eating, speaking, and attending to learning
      • Source: Department of Health and Human Services
    • Importance to Adults
      • For every adult 19 years or older without medical insurance, there are three without dental insurance
      • 164 million hours of lost work each year
      • Source: Department of Health and Human Services
    • Importance to Older Adults
      • Most older adults lose their dental insurance when they retire
      • 30% of adults 65 years and older wear dentures (compared to 46% 20 years ago)
      • 23% of 65-74 year-olds have severe periodontal disease
      • Source: Department of Health and Human Services
    • Periodontal Disease is a Nationwide Epidemic
      • 80% of adults will have some form of periodontal disease
      • 2 nd most prevalent disease in U.S. after heart disease
      • Affects more than 50 million people
      • Only 15-20% receive treatment
      • $6 billion is spent annually to treat the disease in the US
      • Source: U.S. Department of Heath and Human Services
    • The Link Between Periodontal Disease and Overall Health
      • Systemic
        • Diabetes
        • Heart Disease
        • Respiratory Disease
        • Osteoporosis
        • Pre-term, low birth weights
        • Pancreatic Cancer
        • Pneumonia
    • History Repeats Itself * Decade of Growth 2000’s 1990’s POS 1990’s 1980’s PPO 1980’s 1970’s HMO 1960’s 1940’s Insurance Dental * Medical *
    • 21 st Century Medical Trends
      • 2002 HealthAllies Survey
      • 2004 Medicare discount Rx card legislation
      • 2005 CalPERS decision to place cost above access
      • 2006 DMHC decision to regulate discount plans
      • 2006 Wal-Mart Launches $4 Rx
      • 2006 Guardian Survey found 89% of Americans understand oral-health connection
    • 21 st Century Medical Trends
      • 2007 average employee healthcare cost is $7,211*
      • Between 2000 and 2007**
        • Cost of providing health benefits rose 100%
        • Worker wages increased 25%
        • Overall inflation increased 21 percent
      • Employee Health Coverage Continues to Erode
        • 6.4 million fewer workers with employer-provided health insurance in 2006 than 2000
      • *Source: EBRI Issue Brief, Dec. 2007
      • **Source: Economic Policy Institute
    • 21 st Century Medical Trends
      • Integrated medical-dental health plans
        • 2007 Aetna/Columbia University study
          • 145,000 member study found early treatment of perio care resulted in lower overall medical costs for members with diabetes, coronary artery disease and stroke
        • 2008 BC/BS of Tennessee
          • Members who received diagnostic or preventive care had 2% lower healthcare costs ($5.5 million/annual savings)
          • 16% fewer admissions
          • Fewer incidences of coronary artery disease, congestive heart failure, diabetes and hypertension
    • 21 st Century Medical Trends
      • Health risk appraisals are offered by 83 percent of companies (up 18% from ’07)*
      • Introduction of tiered PPO network benefits
      • CDHPs offered & enrolled increase
        • Nearing 50% of employers offer or expect to offer
      • *Source: Watson Wyatt/National Business Group on Health
    • 21 st Century Medical Trends
      • Growing Medical Voluntary Market*
        • Growing individual market – 27 million according to the US Census Bureau
        • Ninety-four percent of medical brokers sell at least some voluntary products
        • Problematic for carriers
      • Growing use of the internet for information**
        • Plays a role in nearly 60% of all health insurance sales
        • 71% of insured people with a carrier for less than three years are still shopping online for insurance
      • Medical tourism: alive and growing
        • *Eastbridge 2007 Spotlight Report
      • **Norvax
    • Traditional Dental Benefits
      • PPO Plans have grown 68% over last 6 years and represent 54% of the dental market
      • Insurance plans have shrunk 53% and now represent 23% of the dental market
      • Dental HMO’s have declined 50% and now represent 14% of the dental market
      • Discount Dental Plans account for 8% of the dental market
      • Direct Reimbursement Plans account for less than 1% of the dental market
      • Source: National Association of Dental Plans
    •  
    • What Do Employers Want?
      • Better benefits for less money
        • Money is always an issue
        • DHMO Irony
      • Network is important - a differentiator
        • Size
        • Discounts
        • Standalone “Best in Class” until outcomes are linked to medical costs (still waiting)
    • Maximizing your PPO Plans
      • Expand your network options
        • Tiered Fee-For-Service Networks (POS)
        • PPO/EPO
        • PPO/DHMO
      • Dual-Purpose PPO networks
        • Free benefits as long as the list of exclusions and limitations
      • Preventive Plus plans
      • M aximum A llowable C harge plans
    • Understanding Dental Networks
      • Golden Age of Dentistry – dentists have the upper hand
      • Dual-purpose PPOs
      • Network Size: Caveat Emptor
      • Network discounts: fixed vs. percentage
      • Specialist discounts
        • Are they different?
        • Are they included?
    • New Types of Plans
      • Exclusive Provider Organization (EPO)
        • Insured
        • Deeper discounted – smaller network
      • Self Funding Increasing
        • Predictable and non-catastrophic
        • Direct Reimbursement (“simple” self-funding)
      • Dental Discount Plans
    • New Bells and Whistles
      • Rollover maximums
      • Family vs. individual maximums
      • Escalating maximums
      • Diagnostic & Preventative maximums
      • Coverage for dental implants
      • Coverage for teeth whitening
      • Coverage for pregnant women
    • Dental Plan Opportunities
      • Everyone should have a network (groups and individuals)
        • PPO
        • EPO
        • DHMO
        • Discount
      • Add deeper discounted networks for additional savings
        • EPO or DHMO with a PPO
        • PPO with deeper discounts
        • PPO with discounts for non-covered services
    • Dental Plan Opportunities
      • Use networks that expand coverage without costing more
      • Direct Reimbursement (“simple” self-funding)
      • Discount Plans
        • Sharp & FDH Access
    • Conclusions
      • Dentistry is expensive and getting more expensive
        • much less than medical but much faster than inflation
      • Dental health directly impacts overall health
      • The Dental Benefits Industry generally follows the Medical Industry
      • Every client or prospect has options for improving or adding a dental benefit
    • Conclusions
      • Options exist for you to save your clients money without taking away benefits
        • Network enhancements
        • Plan design modifications
        • New products
      • Brokers play an important role in educating their clients and prospects
        • Health & welfare and savings