Dental/medical integration Featured

7:00pm EDT December 31, 2006

While offering medical coverage to prospective and current employees is an important attraction and retention tool for employers, it is far from the only health-related benefit that employees are looking for. After medical coverage, dental coverage is always cited as one of the most sought-after employee benefits.

For employers looking to offer both of these benefits to employees, but are also looking to manage the costs, there is an innovative new approach that can both provide improved benefits for employees — keeping them healthier and more productive — and also cut medical costs for the employer.

“While it is great to offer both medical and dental coverage, employers are likely to see better results if they offer an integrated medical/dental program,” says Bill Berenson, vice president of sales and service for Aetna’s Small & Middle Market Business in the North Central Region. “These programs emphasize the connection between oral health and overall health, which helps to keep employees healthier, and they also can help employers manage the cost of care in a variety of ways.”

Smart Business spoke with Berenson, who answered some basic questions about dental and medical integration (DMI) programs and the positive impact they can have for employees and employers.

How would a DMI program help improve employee health?

There is a strong connection between oral health and overall well-being. By having a DMI program, employers are recognizing this connection, which is likely to result in more well-rounded treatment for the employee population.

Which employees would benefit most from an integrated plan like this?

Our research has shown that individuals with certain conditions — such as diabetes, coronary artery disease, cerebrovascular disease (stroke) and even pregnant women — may see the most significant benefit from earlier dental and periodontal care, which is more likely in an integrated program.

A recent study showed that individuals with these conditions who accessed dental care earlier lowered the risk or severity of their respective conditions, and subsequently lowered their overall medical costs.

Is employee outreach an important part of these types of programs?

While offering these programs to employees is an important first step, it is also extremely important to educate employees about the potential benefits they could see. This employee outreach and increase in awareness should attempt to motivate at-risk employees to seek appropriate dental care.

In an educational pilot with 500,000 members starting in 2003, we found that approximately 57 percent of those at-risk members who received education sought subsequent dental care. This high responsiveness indicates a willingness of employees to seek care if they are informed about it.

How does this lead to improved employee productivity?

Employees miss millions of hours a work each year for dental-related illnesses or dental visits, and that number increases for employees who are parents and have to miss time for their children’s dental appointments. An enhanced dental benefit program can help decrease this employee absenteeism by making it more likely for an employee to receive care earlier. This can also decrease ‘presenteeism,’ which is when an employee is at work but is not performing to his or her fullest capabilities.

How would an employer see cost savings from a program like this?

There are several areas where an employer would see savings from a DMI program. By having both medical and dental coverage with the same insurer, administrative costs are likely to decrease. Also, in certain cases where a customer has both medical and dental coverage with the same insurer, these types of integrated programs are actually offered for free.

In addition, the improved health of employees, especially those with certain chronic conditions, can also create savings in health care costs.

Enhanced employee attraction and retention, better overall employee health (leading to improved productivity) and health care cost savings – these are all potential results of an integrated medical and dental program, and they are reasons this type of program should be strongly considered as part of the solutions to any company’s health care process.

BILL BERENSON is vice president of sales and service for Aetna’s Small & Middle Market Business in the North Central Region. Reach him at (312) 928-3323 or berensonw@aetna.com.