MetLife has created two free resources for employers and benefits professionals that offer tips for evaluating the value of dental provider networks.
MetLife provides dental plan administration for nearly 20 million people. The company created a guide, "Taking a Deeper Look at Dental Networks," and a video, "Building Blocks of Dental Benefit Plans," in order to help benefits professionals look at more than simply size and discounts when evaluating a dental provider.
"While accessibility, disruption, and discount reports can provide valuable information when evaluating a carrier network, it is important to recognize each report's inherent limitations," said Dr. David Guarrera, DDS, vice president, MetLife Dental Products. "The new resources help one learn the value and proper use of these reports as well as a new metric, effective discounts. In fact, this metric may be the best indication of the overall impact on benefit plan costs and participant out-of-pocket expenses."
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A large network with negotiated fees for covered services is only valuable if the participants use in-network dentists. The effective discount — the combination of in-network utilization and discount level or total percentage savings on claims from all dentists — may be the best measure of how often the in-network discounts are being used and the overall savings, or value, provided by the network. Analyzing the effective discount along with a carrier's recruitment strategy, service efficiencies and practice pattern review process, can help ensure a more informed assessment of a network's value.
"The effective discount is a powerful metric to know," Guarrera said. "It is also important to consider criteria like plan design, claims management and service excellence to optimize plan value and employee savings and satisfaction."
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