Study: Including Dental Benefits in Medical Plans Is Coming

A new survey has found that many believe dental benefits will be embedded in medical plans in the near future. According to a recent article from the American Dental Association (ADA), 96% of healthcare executives believe it is “already happening or will happen eventually.”

The survey was conducted by West Monroe Healthcare and included 125 executives from dental plans and health plans across the country. The research found that the “vast majority of both dental (82%) and medical (80%) respondents agree that medical plans have a clear or significant advantage over standalone dental insurers in a bundled scenario.”

“It’s absolutely essential that dental plans prepare to be attractive partners, and understand that standing still, or alone, is no longer an option for plans that want to thrive in the future,” said Will Hinde, managing director of West Monroe’s Healthcare & Life Sciences practice and co-author of the report in a press release.

Other findings from the survey include:

  • 39% of dental respondents said they “have plans to partner with health insurers in the next five years” and most believe their benefits will be embedded with a health insurer.
  • 40% of all respondents think employer groups will continue to take a “best-of-breed approach” to insurance offerings, noting one dental plan chief executive officer’s comment that most large employers “want good service for their people, so until medical can provide the same level of service, bundling won’t be attractive.”
  • Several respondents said they believe “technology, regulatory factors, and the convergence of overall and oral health will be the primary drivers of convergence.”

When the federal health care marketplace HealthCare.Gov was created, the ADA Health Policy Institute began studying the issue of embedding dental benefits in medical plans. This research has found that the overall percentage of medical plans offered through HealthCare.Gov that include dental benefits have remained relatively stable, but there has been an increase in the number of states offering embedded medical plans. The HPI study was published in the March 2017 Journal of Pediatrics, and found that the average child would experience lower total financial outlays if a medical plan with embedded dental benefits was purchased instead of two separate plans.

The ADA HPI has also done research on Medicare and dental plans. Last fall, HPI and Oral Health America teamed up to conduct a series of joint focus groups that found the majority of Americans over 50 would like to see dental benefits included in Medicare. These findings are supported by a recent national survey that found 86% of respondents support adding dental care to the services covered by the Medicare program. They also found that the number of older adults who understand the link between oral health and overall health is increasing and that 93% of Americans aged 50 and older want dental coverage included in Medicare. It was also determined that compared to other coverage types, like vision, hearing, long-term care and foot care, dental care was the “top priority.”

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