INTERVIEW: Dental Health And Chronic Disease

posted by AHIP

on December 18, 2018

Dental care is important to all aspects of health, helping prevent chronic disease and lower medical costs. A study from the Capital BlueCross family of companies reinforces the value of preventive dental care for people with chronic health conditions like asthma, diabetes, or heart disease. It found that taking a person-centered, population health approach to dental care could help reduce emergency department visits and hospitalizations.

Health insurance provider Capital BlueCross conducted the two-year study with Dominion National, which assists in administering BlueCross Dental benefits, and Geneia, which provides analytics support.

Leaders from Capital BlueCross, Dominion National, and Geneia recently answered some questions for us about the research and the importance of having quality dental coverage and using it for preventive care.

Tell us about the study and what it means for consumers and the health care industry?

Dr. Jennifer Chambers, Chief Medical Officer, Capital BlueCross: Through this study, we’re really getting a line of sight to what we can study further about why dental health is so important when it comes to physical health and related implications.

Heather Lavoie, President, Geneia: The findings validated what we believe to be the case viscerally. Oral health is a critical component of overall health, and poor oral health leads to serious complications. What we found was consistent with other information out there, that ignoring oral care can exacerbate outside health conditions.

Why is integrating medical and dental coverage and care so important?

Mike Davis, President and Chief Operating Officer, Dominion National: There has always been a gap between medical and dental insurance. It’s been separated since the late ‘60s, in terms of how it’s handled from a medical-dental benefit. But it really is the integration between medical and dental plans to manage the population for a chronic condition as well as managing conditions overall from a medical and dental health perspective.

It’s obvious through studies there’s a lot of chronic conditions related to oral health. It’s understandable that a lot of disease can come through the environment, whether breathing or eating. We’re working through studies like this to come up with evaluations or predictions around what metrics and support we can provide from the management of a dental member to the management of medical member.

Dr. Chambers: There are so many examples where poor oral health can lead to very serious conditions, including heart disease. We know there’s a connection there.

Previously, the strategy in health care was divide and conquer. Mental health, behavioral health, dental health, and medical health were all managed in silos. We needed to focus on the whole person and look at what’s happening across the spectrum to better understand the overall impact.

What should healthcare organizations take away from the study, what are some next steps make the connection between medical and dental care?

Mike Davis: We have the opportunity to better communicate with our medical doctors or pediatricians about how to promote better oral care, particularly for kids. And we can work with our dentists to help them manage their patients.

Chris Davis, Vice President, Ancillary Services, Capital BlueCross: You can help with the issue of opioid misuse. There’s a gray area where dentists are prescribing opioids, but dental companies aren’t necessarily aware of this prescription because the benefit goes through a patient’s prescription coverage. Health care organizations that further combine medical and dental can do a better job of monitoring, educating, and benchmarking opioid prescribing.

Dr. Chambers:  We looked at data integrated across Capital and our dental network to understand the rate of prescription opioid happening and how to get our arms around that. We have that ability to fully integrate the data, and with that access to data we have the opportunity to drive better outcomes through communication with a full network of providers, dentists, oral surgeons, primary care providers, and other specialists.

What are some of the biggest challenges to improving the oral health of people with chronic medical conditions, and what are your organizations doing to overcome them?

Dr. Aurel Iuga, Chief Medical Officer, Geneia: Becoming aware of the bidirectional implications between oral disease and chronic medical disease as clinical and insurance communities is important. Every touchpoint the patient has with a clinical care provider is an opportunity for intervention, for closing care gaps, for addressing medical problems. That touchpoint can occur at the dentist’s office.

Heather Lavoie: We’re constantly diving into topical areas as they relate to medical and dental care and looking at ways we can more easily and at earlier time periods identify ongoing or emerging chronic conditions as well as more serious catastrophic conditions.

This has been edited and condensed for clarity.

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