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Survey: Embedding dental benefits in medical plans is on the way

January 10, 2018

By Jennifer Garvin

Chart showing driving forces behind dental benefits
Courtesy of West Monroe Partners

Chicago — A new survey finds that 96 percent of health care executives believe that the embedding of dental benefits in medical plans is "already happening or will happen eventually."

The survey, which West Monroe Healthcare conducted, polled 125 executives from dental plans and health plans across the country. It found that the "vast majority of both dental (82 percent) and medical (80 percent) 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," Will Hinde, managing director of West Monroe's Healthcare & Life Sciences practice and co-author of the report, said in a press release.

Other key findings of the survey include:

  • 39 percent of dental respondents said they "have plans to partner with health insurers in the next five years" and most expect their benefits to be embedded with a health insurer.
  • 40 percent of all respondents believe 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."
  • Many respondents said they believe "technology, regulatory factors, and the convergence of overall and oral health will be the primary drivers of convergence."

The ADA Health Policy Institute has studied the issue of embedding dental benefits in medical plans since the inception of the federal health care marketplace HealthCare.Gov. In that research, HPI has found that the overall percentage of medical plans offered through HealthCare.Gov that embed dental benefits has remained relatively stable, but there has been an increase in the number of states offering embedded medical plans.

Additionally, an ADA Health Policy Institute study published in the March 2017 Journal of Pediatrics found that the average child would experience lower total financial outlays if a medical plan with embedded dental benefits was purchased instead of a two separate plans.

The ADA Health Policy Institute has also done research on Medicare and dental plans. Last fall, HPI and Oral Health America conducted a series of joint focus groups that found the vast 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 percent of respondents support adding dental care to the list of services covered by the Medicare program.

They discovered that an increasing number of older adults understand the link between oral health and overall health and that 93 percent of Americans age 50 and older want dental coverage included in Medicare. The research also determined that compared to other coverage types such as vision, hearing, long-term care and foot care, dental care was the "top priority."

In the West Monroe Healthcare survey, 50 percent of health care executives said they believed government actions — changes to Medicaid/Medicare and other federal mandates — are one of the top reasons they expect dental benefits to one day be embedded with health insurance.

Read the entire survey here.