A peer-reviewed journal that offers evidence-based clinical information and continuing education for dentists.

Impact of Dental Services on Total Cost of Care

According to claims data analysis from health insurer Cigna, plan members who did not receive preventive dental care had significantly higher per person costs for services such as emergency visits, endodontic treatment and restorations.

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It is well known preventive dental care can improve oral health. It can also save money. According to claims data analysis from health insurer Cigna, plan members who did not receive preventive dental care had significantly higher per person costs for services such as emergency visits, endodontic treatment and restorations. The difference was largest for emergency visits and root canal procedures, which had 129% and 128% higher average per person costs, respectively, for individuals who lacked preventive care.1


The issue becomes even more serious when it comes to periodontal disease, as the literature suggests a link between periodontitis and the worsening of chronic systemic diseases, such as type 2 diabetes and cardiovascular disease.2 Cigna found that patients being treated for periodontal conditions had a significant reduction in both emergency visits and hospitalizations compared to those whose periodontal disease was untreated.3
For dentists, this matters because preventable emergency visits and hospitalizations are a significant target in efforts to reduce the total cost of care. The federal Centers for Medicare and Medicaid Services is now in the fourth year of its Quality Payment Program and is encouraging hospitals, health systems and providers to enter into alternative payment systems in which clinicians are rewarded for reducing the cost of care, and financially penalized if they do not. If preventive dental care and periodontal treatments turn out to be reliable ways to reduce costs, as the data indicate, look for greater interest from insurance payers in partnering with dentists on population health initiatives.

REFERENCES

  1. Cigna. Long-term dental care and its impact on dental costs. Available at: https://www.cigna.com/static/www-cigna-com/docs/employers-brokers/dental-white-paper.pdf. Accessed March 23, 2020.
  2. Seitz MW, Listl S, Bartols A, et al. Current knowledge on correlations between highly prevalent dental conditions and chronic diseases: An umbrella review. Prev Chronic Dis. 2019;16:180641.
  3. Cigna. Preventive dental treatment associated with lower medical utilization and costs. Presented at the International Association for Dental Research Meeting, Boston. March 2015. Updated with 2018 Data. Available at: https://www.cigna.com/static/www-cigna-com/docs/employers-brokers/dental-white-paper.pdf. Accessed March 23, 2020.

From Decisions in Dentistry. April 2020;6(4):46.

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