Dental Benefits Overview and National Trends in Oral Healthcare
DELTA DENTAL OF RHODE ISLAND
Dental Benefits Overview
Dental Benefits Overview
R.I. Oral Healthcare Landscape
R.I. Oral Healthcare Landscape
Delta Dental Statistical Snapshot
Delta Dental Statistical Snapshot
Access to Care &
Access to Care &
Workforce Development
Workforce Development
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Updated national trends based on latest available data as of
November 2023 (Updated March 2024):
Estimated that 43% of U.S. population visited a dentist in 2021
Among adults, 61% have private dental insurance
Compared to other types of health care services, cost barriers are
most severe for dental care services
For example, 13% of the population reported cost barriers to dental care,
compared to 4-5% for other health care services
Across all age groups, compared to individuals with public dental
insurance or no dental insurance,
those with private dental
benefits have the lowest levels of cost barriers to dental care
Source: American Dental Association – Health Policy Institute Reporting November 2023 (Updated March 2024)
“National Trends in Dental Care Use, Dental Coverage, and Cost Barriers”
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National Association of Dental Plans (NADP)
research reveals
record number of Americans with dental coverage:
Nationally, 88% of population enrolled in dental benefits
programs
A record 293 million Americans had dental coverage according to
the NADP’s 2023 Benefits Report
Breakdown of population with dental coverage includes:
Americans enrolled in employer-sponsored or other group plans;
Individual dental benefit plan purchasers; and
Those enrolled in publicly funded programs
Publicly funded dental enrollment is increasing significantly
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Census Bureau estimates
Rhode
Island population at 1,095,962
As of July 2023
Down from 1,097,371 in 2020
Census
92% of R.I.’s population has some
form of dental coverage
Well above national average
RI ranked #6 in nation
for adult
dental visits
RI employer groups offer
some of
the richest dental benefit packages in
the nation
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NEWLY CREDENTIALED DENTISTS 2013 - 2023
452 Dentists Credentialed last 10 years / 65 different dental schools / Average age 37
72% under age 40 / Tufts graduates at 93 / Boston U. at 119 / UCONN at 13
~60% are still practicing in Rhode Island
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STATISTICAL SNAPSHOT
Credentialed = 54
Average age = 35
Under Age 40 = 83%
Dental schools = 26
Tufts = 14 graduates
Boston U. = 8 graduates
UCONN = 3 graduates
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The Rhode Island dental market can be examined by focusing on
workforce demographics and access to dental care
Utilizing DDRI’s database of claims paid to both in-network and out-of-
network dentists, along with credentialing data, a comprehensive view
of actively practicing dentists in Rhode Island can be reported.
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STATISTICAL SNAPSHOT 2013 VS. 2023
Slight increase in Endodontic volume of service per member
General Dentists and other specialists volume of service per member is relatively flat
43% increase in under age 40 dentists providing care vs. 8% decrease in over age 40
RI dental carriers are
heavily regulated:
DBR (
Department of
Business Regulations
)
OHIC (
Office of Health
Insurance Commissioner
)
SORI, IRS, etc.
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407,000 members (DDRI in-state and out-of-state)
Nearly 3,000 active DDRI clients:
State of Rhode Island
Citizens Financial Group
Lifespan
RI Interlocal Trust
Client Financial Arrangements (as a % of membership):
Self-insured = 66%
Fully-insured = 34%
Client cost obligations built into premiums:
State premium tax = ~$19million over last 10 years
Broker commissions = ~$24million over last 10 years
Program includes
additional
Value-based-care reimbursements:
More than $50million in value based care reimbursements made to RI dentists over
last 10 years
Net premium per month per member = <$31
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Delta Dental of Rhode
Island members are
recording dental visits
at a pace well above
national averages
Delta Dental of Rhode
Island members under
age 18 are receiving
services at local and
nation leading levels
Overall satisfaction
Satisfied w/ availability
of dentists
Satisfied w/ quality
of dental treatment
Would recommend
to family/friends
92%
93%
98%
94%
Satisfied w/
customer service
experience
94%
Having insurance increases
likelihood of going to
dentist
95%
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Lifespan/RI Hospital – Samuels Sinclair Dental Center
Rhode Island Department of Education
Rhode Island Health Professional Loan Repayment
Program
Rhode Island Free Clinic
RI Oral Health Foundation & RI Mission of Mercy
Rhode Island Kids Count
Rhode Island Health Center Association
Children’s Friend
C.C.R.I. - Dental Hygiene Program
Providence Community Health Centers
Blackstone Valley Community Health Care
Thundermist Health Center
Dental Lifeline Network
Wood River Health
Tri-County Community Action Agency
Junior Achievement of Rhode Island
Care New England Health System
Tufts University School of Dental Medicine
Crossroads Rhode Island
Comprehensive Community Action Program
CareLink
American Heart Association
Increasing Access
to Care
Investing in RI’s
Workforce
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10 years of
RI
Mission of
Mercy
Expanding
Access in the
West Bay
Expanding
and
supporting
CCRI’s
Dental
Hygiene
Program
Creating RI’s
first oral
surgery
residency
program
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DDRI/CCRI asked to share partnership success with:
Hawaii Dental Service (DDHI)
Hawaii Chamber of Commerce
University of Hawaii Director of Workforce Development
Healthcare Association of Hawaii Workforce Development
Strong interest from other states to replicate this program to
address the
national shortage of dental hygienists
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Continued Focus on Workforce Development
DENTAL HYGIENISTS:
Expand the CCRI Partnership
Additional scholarships
Potential longer time commitment to working in Rhode Island
DENTAL ASSISTANTS:
CCRI, RI Department of Education, and Westerly
Education Center opportunities
Aligns with high school career and technical training programs to build
Oral
Health Career Pathways
Targeting: East Providence, Lincoln, Westerly, others
PROVIDER RECRUITMENT:
Potential of expanding contributions to Loan
Repayment Programs for Providers working in Community Health Centers
Explore the importance of dental benefits in the workplace, including retirement savings programs, insurance coverage, and the latest national trends in dental care. Learn about access to care, cost barriers, and the high demand for comprehensive dental benefits in today's workforce.
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Presentation Transcript
DELTA DENTAL OF RHODE ISLAND HEALTHCARE SUMMIT MAY 28, 2024
Dental Benefits Overview 1 R.I. Oral Healthcare Landscape 2 3 Delta Dental Statistical Snapshot Access to Care & Workforce Development 4
DENTAL BENEFITS OVERVIEW DENTAL BENEFITS OVERVIEW The 7 Most In-Demand Employee Benefits Right Now 1. Retirement Savings And Financial Wellness Programs According to a survey by the Employee Benefit Research Institute, more than 80% of workers expect their workplace retirement savings plan to be a source of income in retirement. Offering 401(k) plans, pension plans, and other retirement savings options demonstrates a company's commitment to its employees' long-term financial security. In addition, financial wellness programs that provide resources, education, and counseling can help employees manage their finances and reduce stress. 2. Insurance Coverage Health insurance remains a top priority for employees, with 93% of companies with 50 or more workers offering those benefits, according to a Kaiser Family Foundation report. As healthcare costs continue to rise, comprehensive insurance coverage including dental and vision benefits is crucial for attracting talent. Employers should also consider offering life, disability, and accident insurance to provide employees with a well-rounded package that addresses their diverse needs.
DENTAL BENEFITS OVERVIEW DENTAL BENEFITS OVERVIEW Updated national trends based on latest available data as of November 2023 (Updated March 2024): Estimated that 43% of U.S. population visited a dentist in 2021 Among adults, 61% have private dental insurance Compared to other types of health care services, cost barriers are most severe for dental care services For example, 13% of the population reported cost barriers to dental care, compared to 4-5% for other health care services Across all age groups, compared to individuals with public dental insurance or no dental insurance, those with private dental benefits have the lowest levels of cost barriers to dental care Source: American Dental Association Health Policy Institute Reporting November 2023 (Updated March 2024) National Trends in Dental Care Use, Dental Coverage, and Cost Barriers
DENTAL BENEFITS OVERVIEW DENTAL BENEFITS OVERVIEW
DENTAL BENEFITS OVERVIEW DENTAL BENEFITS OVERVIEW National Association of Dental Plans (NADP) research reveals record number of Americans with dental coverage: Nationally, 88% of population enrolled in dental benefits programs A record 293 million Americans had dental coverage according to the NADP s 2023 Benefits Report Breakdown of population with dental coverage includes: Americans enrolled in employer-sponsored or other group plans; Individual dental benefit plan purchasers; and Those enrolled in publicly funded programs Publicly funded dental enrollment is increasing significantly
RHODE ISLAND ORAL HEALTHCARE LANDSCAPE RHODE ISLAND ORAL HEALTHCARE LANDSCAPE Census Bureau estimates Rhode Island population at 1,095,962 As of July 2023 Down from 1,097,371 in 2020 Census RI ENROLLMENT TYPES 8% 9% 14% 56% 92% of R.I. s population has some form of dental coverage Well above national average RI ranked #6 in nation for adult dental visits RI employer groups offer some of the richest dental benefit packages in the nation 13% Commercial Insurance/Discount Programs Rite Smiles (childrens Medicaid dental) Medicaid Medicare No coverage
RHODE ISLAND ORAL HEALTHCARE LANDSCAPE RHODE ISLAND ORAL HEALTHCARE LANDSCAPE NEWLY CREDENTIALED DENTISTS 2013 - 2023 452 Dentists Credentialed last 10 years / 65 different dental schools / Average age 37 72% under age 40 / Tufts graduates at 93 / Boston U. at 119 / UCONN at 13 ~60% are still practicing in Rhode Island
RHODE ISLAND ORAL HEALTHCARE LANDSCAPE RHODE ISLAND ORAL HEALTHCARE LANDSCAPE STATISTICAL SNAPSHOT Credentialed = 54 Average age = 35 Under Age 40 = 83% Dental schools = 26 Tufts = 14 graduates Boston U. = 8 graduates UCONN = 3 graduates NEWLY CREDENTIALED RI DENTISTS NEWLY CREDENTIALED RI DENTISTS - - 2023 ONLY 2023 ONLY
RHODE ISLAND ORAL HEALTHCARE LANDSCAPE RHODE ISLAND ORAL HEALTHCARE LANDSCAPE The Rhode Island dental market can be examined by focusing on workforce demographics and access to dental care Utilizing DDRI s database of claims paid to both in-network and out-of- network dentists, along with credentialing data, a comprehensive view of actively practicing dentists in Rhode Island can be reported.
RHODE ISLAND ORAL HEALTHCARE LANDSCAPE RHODE ISLAND ORAL HEALTHCARE LANDSCAPE STATISTICAL SNAPSHOT 2013 VS. 2023 Slight increase in Endodontic volume of service per member General Dentists and other specialists volume of service per member is relatively flat 43% increase in under age 40 dentists providing care vs. 8% decrease in over age 40
RHODE ISLAND ORAL HEALTHCARE LANDSCAPE RHODE ISLAND ORAL HEALTHCARE LANDSCAPE SAMPLE REPORTING ACTIVITY FOR DENTAL INSURERS RI dental carriers are heavily regulated: DBR (Department of Business Regulations) OHIC (Office of Health Insurance Commissioner) SORI, IRS, etc. Regulation *Benefit Determination and Utilization Review Act [RIGL 27-18.9]. *Fully-insured groups - claims/appeals with number approved & denied, number sent to external review *Health Care Accessibility and Quality Assurance Act [RIGL 27-18.8] Fully-insured groups - complaints, resolution time and enrollment *OHIC Regulation 230-RICR-20-30-9 (Network Plans), Section 9.6(A)(3): *Regulation 216-RICR-10-10-5 - All Payor Claims Database - Claims & enrollment data (Monthly), and value-based-care payments (Annually) *RIDBR 10 Corporate Governance Annual Disclosure (CGAD) *RIDBR 03 - Annual Report of Risk Based Capital *RIDBR 09 - Ins. Holding Co. Systems - Applicable Form C (RIDBR) (FORMS B, C, F and questionnaire) *RIDBR 11 - Audited Financial Statements -RIDBR (Ins. Reg 87) Description Frequency OHIC Quarterly & Annually OHIC Annually & Bi- annual OHIC Annually SORI Monthly & Annually DBR DBR Annually Annually DBR Annually DBR Annually Annually Quarterly *RIDBR 01 - Annual & Quarterly Reports DBR *IRS 09 - Form 990 (Information Return for Exempt Organizations) IRS Semi-Annually
DELTA DENTAL STATISTICAL SNAPSHOT DELTA DENTAL STATISTICAL SNAPSHOT 407,000 members (DDRI in-state and out-of-state) Nearly 3,000 active DDRI clients: State of Rhode Island Citizens Financial Group Lifespan RI Interlocal Trust Client Financial Arrangements (as a % of membership): Self-insured = 66% Fully-insured = 34% Client cost obligations built into premiums: State premium tax = ~$19million over last 10 years Broker commissions = ~$24million over last 10 years Program includes additional Value-based-care reimbursements: More than $50million in value based care reimbursements made to RI dentists over last 10 years Net premium per month per member = <$31
DELTA DENTAL STATISTICAL SNAPSHOT DELTA DENTAL STATISTICAL SNAPSHOT Rhode Island Population = 1,095,962 DDRI also has another 140,000 members who live out-of-state through its Rhode Island client base: Citizens Hasbro FM Global Amica Toray etc. 138,000 690,962 267,000 DDRI Rhode Island Resident Members Delta Dental Sister Plans Rhode Island Resident Members Remaining population
DELTA DENTAL STATISTICAL SNAPSHOT DELTA DENTAL STATISTICAL SNAPSHOT Delta Dental of Rhode Island members are recording dental visits at a pace well above national averages Delta Dental of Rhode Island members under age 18 are receiving services at local and nation leading levels
DELTA DENTAL STATISTICAL SNAPSHOT DELTA DENTAL STATISTICAL SNAPSHOT Satisfied w/ availability of dentists Overall satisfaction 92% 93% Satisfied w/ quality of dental treatment Would recommend to family/friends 98% 94% Satisfied w/ customer service experience Having insurance increases likelihood of going to dentist 94% 95%
ACCESS TO CARE & ACCESS TO CARE & WORKFORCE DEVELOPMENT WORKFORCE DEVELOPMENT Primary Areas of Support General Community Support 29% Access to Care Grants 34% Education/ Workforce Development Funding 37%
ACCESS TO CARE & ACCESS TO CARE & WORKFORCE DEVELOPMENT WORKFORCE DEVELOPMENT Sample Beneficiaries of Support Lifespan/RI Hospital Samuels Sinclair Dental Center Rhode Island Department of Education Rhode Island Health Professional Loan Repayment Program Rhode Island Free Clinic RI Oral Health Foundation & RI Mission of Mercy Rhode Island Kids Count Rhode Island Health Center Association Children s Friend C.C.R.I. - Dental Hygiene Program Providence Community Health Centers Blackstone Valley Community Health Care Thundermist Health Center Dental Lifeline Network Wood River Health Tri-County Community Action Agency Junior Achievement of Rhode Island Care New England Health System Tufts University School of Dental Medicine Crossroads Rhode Island Comprehensive Community Action Program CareLink American Heart Association
ACCESS TO CARE & ACCESS TO CARE & WORKFORCE DEVELOPMENT WORKFORCE DEVELOPMENT Increasing Access to Care Investing in RI s Workforce Expanding and supporting CCRI s Dental Hygiene Program 10 years of RI Mission of Mercy Creating RI s first oral surgery residency program Expanding Access in the West Bay
ACCESS TO CARE & ACCESS TO CARE & WORKFORCE DEVELOPMENT WORKFORCE DEVELOPMENT Local & National Example for Successful Workforce Development Local & National Example for Successful Workforce Development DDRI/CCRI asked to share partnership success with: Hawaii Dental Service (DDHI) Hawaii Chamber of Commerce University of Hawaii Director of Workforce Development Healthcare Association of Hawaii Workforce Development Strong interest from other states to replicate this program to address the national shortage of dental hygienists
ACCESS TO CARE & ACCESS TO CARE & WORKFORCE DEVELOPMENT WORKFORCE DEVELOPMENT FUTURE OPPORTUNITIES FUTURE OPPORTUNITIES Continued Focus on Workforce Development DENTAL HYGIENISTS: Expand the CCRI Partnership Additional scholarships Potential longer time commitment to working in Rhode Island DENTAL ASSISTANTS: CCRI, RI Department of Education, and Westerly Education Center opportunities Aligns with high school career and technical training programs to build Oral Health Career Pathways Targeting: East Providence, Lincoln, Westerly, others PROVIDER RECRUITMENT: Potential of expanding contributions to Loan Repayment Programs for Providers working in Community Health Centers
