A few years ago, Cigna, one of the largest providers of dental insurance, started collecting data on its customers’ dental bills.
The company, which is part of Anthem Blue Cross Blue Shield, wanted to figure out if they were paying out-of-pocket for dental treatment or if they just had bad insurance.
So it started tracking dental bills, which include payments to providers, and what kinds of treatments they received, and then used that data to predict whether or not they would be billed.
In some cases, they could predict whether a person would have a dental infection, and in others, they found that they were unlikely to have one.
“I started to wonder, if I had a bad policy, why am I paying for things I can’t use?” says Cignas executive director, Tom Cignos.
And the answer was that many consumers have dental insurance because they don’t think about dental care as an expense.
“The problem is that if you are not spending money on things that are going to help you or protect you, you’re paying a lot more in dental insurance than you should,” says Cinca.
“And that can make you a lot less likely to pay for dental treatments you can actually use.”
So Cigns researchers used data on what dental insurance consumers were paying for and what types of treatment they were getting to estimate what they should be paying out of pocket.
They also took into account what insurance companies charge and what kind of premiums they were charging consumers.
Their research showed that dental insurance is a very poor predictor of dental care utilization.
The study showed that people who had dental insurance paid $5,600 in dental costs each year on average.
But the researchers didn’t see a significant effect of dental coverage on how often patients were seen.
“What we found is that dental coverage did not appear to have an effect on the utilization of patients,” says Mark Bove, the Cignaus chief executive.
But Cignus was surprised to find that dental benefits were actually hurting people.
“If you had a $50,000 dental plan, and you had $50 in dental benefits, it would not have a significant impact on how many patients you see,” he says.
“You would get fewer people than you would with a $100,000 plan.
But with a dental plan that costs $100 per visit, the benefits are very large.”
Bove says that in the United States, only about 3% of people get dental coverage, and the average amount spent on dental care is about $2,000 per person.
“This is a big surprise to us,” says Bove.
“We were expecting that if we had a lot of dental benefits that we would see a huge increase in dental utilization.”
He says that the study showed what dental care providers charge consumers, but that they don.
“Our estimate is that there is about a $500 premium per visit to dental care for every $1 that dental care provider charges,” says Mike Guereca, a consumer affairs analyst at the Consumer Federation of America.
“It is a lot higher than what we see in other countries.”
Bovid’s Bove thinks the study could have been a lot better done.
“There is no evidence that dental benefit is associated with dental utilization,” says Guereyca.
“So this study is not the best we have.”
Bose says that if insurance companies can learn from Cignans research, they can figure out what to charge consumers and make sure that they are getting the best value for money.
And he says that they could use the data to get more patients covered.
“They can then tell them that they can get better value for their money by choosing to get coverage from the best dental providers and making sure they get the care they need,” says the Cincy, Ohio, dentist.
“People need to make choices about what is best for them.”