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Lower Medical Claims Costs Linked to Payer's Dental Program

Margaret Dick Tocknell, for HealthLeaders Media, October 23, 2013

Six years after launching a dental medical integration program, Aetna reports that hospital admissions and claims costs are down, while diabetes control has improved by 45% among 1.5 million patients.

Much of the traditional focus of the care continuum has been to link pre-acute, inpatient, and post-acute healthcare in an effort to improve outcomes and reduce inpatient readmissions. While medical doctors and specialists have long been essential players, dentists are now being added to the mix as health insurers pay attention to the relationship between physical health and dental health.

In 2007 Aetna launched its dental medical integration program as part of a research program with the Columbia University College of Dental Medicine. The DMI program uses claims data to identify Aetna members who are pregnant, have diabetes or cardiovascular disease, and haven't visited a dentist lately. An outreach program connects with those members.

Six years and 1.5 million patients later, Aetna has released some results. DMI program members who visited the dentist have:

  • Lowered their medical claims costs by 17%
  • Improved diabetes control by 45%
  • Reduced their use of major and basic dental services by 42%
  • Required 3.5% fewer hospital admissions year-over-year compared to a 5.4% increase for non-DMI members
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1 comments on "Lower Medical Claims Costs Linked to Payer's Dental Program"


Keaven Wright,RN,MSN,CRRN (10/30/2013 at 11:47 AM)
It is amazing to me that insurance companies haven't picked up on this before. of course a person with good dental health is going to be healthier than some one who does not. If a person can't chew healthy fresh fruits and vegetables the only option left is overcooked mushy ones and that leads to poor nutrition, high blood sugar , wight gain, high cholesterol and general malnutrition and poorer overall health. It is cheaper to stay healthy than it is to be sick ~!!! good dental health is one of the most important foundations to good health. neglect your teeth at your peril. Sometimes Insurance companies are penny wise and pound foolish!!!!! If Premiums for Insurance don't cover dental health care and check ups then often the cost is so much more over the long term.