With a growing body of research indicating a strong potential link between oral health and overall health, employers are beginning to recognize that helping employees control the costs and illnesses associated with dental disease is important. In fact, 64% of employees who say that they have good or better dental health also report very good or better overall health, according to MetLife’s 8th annual Employee Benefits Trends Study. The connection between diabetes and periodontal (gum) disease is a good example of this relationship.
There is growing acceptance among health care professionals that diabetes is associated with increased occurrence and progression of periodontitis–so much so that periodontitis has been called the “sixth complication of diabetes.” Periodontal disease is more common in people with diabetes. Among young adults, those with diabetes have about twice the risk of periodontal disease than those without diabetes. Additionally, those with poorly controlled diabetes were nearly three times more likely to have severe periodontitis than those without diabetes.
Given the connection between oral health and overall health, dental disease management programs are emerging as a beneficial program for both employers and employees.
The reasons for this include the fact that:
Many employers are confused about what constitutes an effective dental disease management tool for two reasons: Dental disease management programs are still a relatively new concept and most approaches provide bits and pieces of what a comprehensive dental disease management program should be.
An effective dental disease management program starts with an appropriate dental plan design and should be flexible enough to work with medical disease management and wellness programs, or perform as a stand-alone solution. To deliver the most value to employers and employees, dental disease management programs should contain these components, working in conjunction:
Employee Engagement
Most employers understand that a program can only be successful if employees are engaged. When it comes to dental disease management programs, only through continued use of the program will employees and employers see the true value of dental disease management–as it is the component that helps track and manage dental health and risk over time. At a minimum, dental disease management programs should have a strategy for each key touch point:
Disease Risk and Severity Scoring
Scoring helps employees measure, understand, and track their risk and severity of dental disease, so they can see how their risk for, and level of, dental disease changes over time. Data are critical to the risk and severity scoring process. The more data points used, the higher the confidence level. Information can be collected through several ways:
In addition, scoring can provide the dental disease management program with a vehicle to present employees with education relevant to their individual needs.
Targeted Relevant Education
The education component of a dental disease management program should be the foundation of the program. It should be robust enough to stand on its own for employees who want to simply learn about maintaining or improving their oral health, and it should support later components that push relevant education to employees based on their oral health and risk for dental disease.
The education component should also contain reliable, timely information, and should address the associations between oral health and overall health. It should also be easy to navigate, and contain interactive tools like risk assessments.
After presenting employees with the tools and education to assess their dental disease risk, the disease management program should provide employees with active information on timeliness for greatest impact–such as when they receive their risk and disease scores. For example, diabetics can get information about the link between diabetes and periodontal disease and tips to manage their oral health. Other information sources could include links to articles and resources that are relevant to their specific oral health needs, a summary that identifies notable health concerns or a recommended action plan that includes a list of suggestions employees can follow to help improve oral health.
This proactive push of education relevant to employees’ needs may help promote even greater understanding of employees’ risk and disease.
Analysis/Reporting
Aggregate-level reporting provides employers with valuable insights that can demonstrate how benefit plans and disease management programs are functioning and can help employers better understand the health of their employee populations. For example, a dental disease management program can report:
The reporting component of a dental disease management program should be designed to be HIPAA compliant, keep employees engaged and measure the dental health of a population and dental services use over time. Employees can see how their risk for, and their level of dental disease, changes over time and how their actions impact their scores. Furthermore, employers can see how employees are using their dental benefits and changes in the dental health of the population.
Plus, if a medical disease management vendor is engaged, the dental disease management program may have the ability to supply the same reports that are shared with employers and possibly employee-specific information, including employees’ individual risk and disease scores and histories of dental treatments with the employer’s other vendors. Ideally, this information can be incorporated into employers’ other health and wellness programs.
Continuous Looping Engagement and Reporting Time Span
Finally, a dental disease management program should be designed to help keep employees engaged and measure their dental health, and their utilization of dental disease management programs over time. For employees, this allows them to see how their risk and level of dental disease changes as they participate in the program. Additionally, it provides ways to track how their actions have positively influenced their dental health.
One of the differences between true disease management programs and wellness programs is the participant tracking component in disease management. A participant’s changes in health and risk status needs to be tracked over time such that correlations can be made between the change that occurred and what drove the change. For example, did the participant embrace the education regarding the risk correlation between diabetes and gum disease by seeking treatment for their gum disease [substantiated through dental plan utilization data], and did this treatment lower their risk and severity score? This tracking closes the continuous loop component of disease management as the participant is continuously engaged in the program over time as risk and severity changes occur due to changes in behavior.
Through ongoing tracking and measuring, employers will gain a historical perspective on how employees within the program are using their dental benefits and will be able to assess employee engagement in the program. Furthermore, employers will be able to track changes in the dental health of their employees.
Offering an appropriate dental benefit plan design is an important first step. Employers can consider making additional changes after they have a better understanding of the health of their employee population and how existing benefits are utilized.
At a time when employers are seeking to control health and wellness costs, and the burden of paying for these services increasingly falls on employees, dental disease management programs are an effective way for employers to increase the value of their dental benefits program for both themselves and their employees, while simultaneously working to control overall costs.