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New insurance coverage rewards diabetics who treat periodontal disease

April 09, 2012

By Kelly Soderlund, ADA News staff

United Concordia Dental will begin offering a new insurance plan that covers the oral health maintenance diabetics seek after receiving treatment for periodontal disease.

The new program, called UCWellness, is being rolled out following a study, which the author and sponsor are calling the first of its kind. The study looked at how treating periodontal disease can affect the health care costs associated with diabetes. The results showed that hospitalizations decreased by 33 percent annually and physician visits by 13 percent in diabetics who treated and managed their periodontal disease over a three-year period, reducing their medical costs by around $1,800 per year per patient.

UCWellness includes additional periodontal maintenance procedures and 100 percent coverage, subject to deductibles and annual maximums, on periodontal maintenance, scaling and root planing and several periodontal surgical codes.

United Concordia Dental, a Harrisburg, Penn., based insurance company, and Highmark Inc., United Concordia’s parent company, paid for the study to be conducted at the University of Pennsylvania by Dr. Marjorie Jeffcoat, a professor and dean emeritus and former editor of the Journal of the American Dental Association.

United Concordia officials believe UCWellness will be attractive to employers looking to cut their own health insurance costs.

“Keeping employees healthy is not only good for employees but good for business and good for the bottom line,” said Chip Merkel, president and chief operating officer for United Concordia.

Dr. Jeffcoat’s study analyzed data over a three-year period from nearly 1.7 million people insured with United Concordia Dental and Highmark’s medical coverage. Among the 1.7 million, more than 90,000 were diabetic who either elected to receive periodontal treatment or not in 2007, said Dr. Jeffcoat, who presented her findings March 23 to more than 2,500 attendees at the American Association for Dental Research annual meeting in Tampa, Fla.

“This study is so important to us when you look at the sheer size of the study and the scope of the study as well as the statistical significance of the results that Dr. Jeffcoat found. What it says is the results are no fluke—when diabetics have their periodontal disease treated, it not only helps the patient become healthier, it saves money in the long run,” said Dr. Jim Bramson, chief dental officer for United Concordia and former executive director of the ADA.

UCWellness will also include education for diabetics to help them understand the disease and remind them when to visit their doctor, Dr. Bramson said.

“We believe this is a good practice for our company and for the industry to embrace,” Dr. Bramson said. “Treating chronic conditions is a very high cost. Dental disease is preventable at a much lower cost.”

According to the Centers for Disease Control and Prevention, more than 25.8 million people had diabetes in 2011, a number that has more than doubled since 1999. When asked about the link between diabetes and periodontal disease, Dr. Jeffcoat said any type of infection can exacerbate diabetes.Periodontal disease is an infection so if it can be controlled, it can help control a person’s diabetes, she said.

Dr. Jeffcoat plans to expand her research to look at pharmacy costs for diabetics and economic data for other chronic diseases. The study will also analyze other chronic diseases and conditions such as heart attacks, strokes and pregnancy with pre-term birth. The hope is for United Concordia to expand UCWellness to cover additional diseases, Dr. Bramson said.

“A considerable amount of literature exists pointing to an association between dental disease and certain medical conditions,” Dr. Jeffcoat said. “The number of individuals’ data in this study makes it the largest of its kind and is clinically significant, in my opinion.”

Dr. Bramson said UCWellness is the first program to offer this level of coverage for diabetes, specifically the enhanced surgical benefit. In the past, wellness programs at United Concordia and other insurance companies have rewarded lifestyle changes but now there is a program that is aimed at reducing health care costs over time, Dr. Bramson said.

“This is a big step forward. It demonstrates the value of good oral health care and its role in helping to achieve improved general health outcomes,” said Dr. Daniel Meyer, ADA senior vice president of science and professional affairs. “This program appears to be consistent with recent World Health Organization initiatives, which focus on risk assessment, disease management and prevention. It also aligns with the United Nations September Summit, which targeted four noncommunicable diseases, such as diabetes, and the relationships to oral health. International and national public health programs are becoming more aware of the importance of good oral health care to help promote and sustain optimal health at all ages.”

To learn more about the UCWellness program visit www.UnitedConcordia.com.