With many employers looking for ways to manage rising health-related costs, disease management and wellness programs are growing in popularity. Disease management programs, while an accepted medical practice, are still relatively new in the dental field. However, given the growing acceptance of the association of oral health to overall health, the importance of dental benefits to employees, and the desire among employers to derive more value from their benefit plans, dental disease management is a reasonable next step.

What exactly constitutes a comprehensive dental disease management program? According to MetLife, to deliver the most value to employers and employees, dental disease management programs should contain these components, working in conjunction: employee engagement, disease risk and severity scoring, targeted relevant education, analysis/reporting, and continuous looping engagement and reporting over time. It also needs to be easy for employers to implement and employees to participate to be effective. MetLife's disease management solution, the MetLife Dental Health Manager^SM, is offered to group customers with 500 or more employees at little or no additional cost¹.

Dr. David Guarrera, DDS, vice president, MetLife Dental Product Management, says, "Effective dental disease management programs have the potential to benefit both employees and employers with healthier outcomes and cost mitigation. A robust education platform combined with the systems and processes needed to measure and monitor the health of employees and their utilization of benefits over time can help influence healthier behavior."

Components of an Effective Dental Disease Management Program

An effective dental disease management program should be supported by a dental plan design that appropriately provides coverage for dental services that prevent as well as treat dental disease. The program should also be flexible enough to coordinate with an employer's current medical disease management or other wellness programs, or perform as a stand-alone solution. The other components include:

1) Employee Engagement. The employee engagement component should be designed to help employers and employees get the most value out of the program by driving participation and ongoing, sustainable involvement. It is the component that helps employees identify and learn about their dental health and risk over time. Ongoing communications are important and should be targeted to program participants, delivered at least once a year, and/or at a time when employees' risk level and/or disease level may have changed.

2) Disease Risk & Severity Scoring. Scoring helps employees measure, understand and track their risk and severity of disease. This enables them to see how their risk for and their severity of dental disease changes over time and how their actions, or lack of action, affect their scores. For scoring, dental disease management programs can use self-reported health data, claims utilization data, and if available, data from medical disease management vendors.

3) Targeted Relevant Education. Education should serve as the foundation of a dental disease management program. It should be robust enough to stand on its own for employees who want to learn about oral health by themselves, and more importantly, support the later components that push relevant education to employees based on their oral health and risk for dental disease. The education component should contain reliable, timely information and should address the associations between oral health and overall health. It should be easy-to-navigate and contain interactive tools like risk assessments.

After being presented with their scores for risk and severity of disease, the dental disease management program should provide employees with prompt actionable information, such as:

Links to articles and resources relevant to their specific oral health needs;
A summary of health concerns they should take note of; and
A recommended action plan that employees can follow to help improve their oral health.

4) Analysis/Reporting. Aggregate-level analysis and reporting provides employers with valuable insights that can illustrate how benefit plans and disease management programs are functioning, and can help employers better understand the health of their employee populations. A dental disease management program can report on participation, risks, health conditions, change in health risk, claim costs, and dental claim utilization analytics.

5) Continuous Looping Engagement and Reporting Over Time. Employers can gain a historical perspective on how employees within the program are using their dental benefits, the degree of employee engagement in the program and changes in the dental health of the population. If engaged, medical disease management vendors may be provided with historical employee-specific information.

"After employers have a better understanding of the health of their employee population and how existing benefits are used, they can more effectively consider making dental plan design changes," adds Dr. Guarrera.

To help employers and brokers understand more about dental disease management programs, MetLife has available a free guide, Dental Disease Management: What Makes an Effective Program - click here to download.

¹ If a medical disease management vendor is engaged, a setup fee may apply for the transfer of data files.

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Delivering Greater Value to Clients&#039; Dental Benefits Through Dental Disease Management

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Delivering Greater Value to Clients' Dental Benefits Through Dental Disease Management