Lower Medical Claims Costs Linked to Payer's Dental Program

Margaret Dick Tocknell, 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
Margaret Dick Tocknell Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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