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Best Indicator of How Dental Plans Measure Up
Over the past few years, dental plans have been asked to help develop programs to quantify their value to the employee benefit package as well as to evaluate their overall performance. Knowing how quickly claims are paid or that credentials of dentists are verified is important; but ultimately, this information only gives part of the picture. Many benefit consultants and consumer advocates believe the best way to measure the quality of a dental plan, and therefore the value employers are receiving, is through quantifying the experience the employee receives at the point of service.
However, the challenge for employers has been how to secure accurate, balanced and meaningful data containing this information. This is important data for employers to have. If an employee receives poor service from a dentist contracted with the plan, they might believe that all dentists in the plan give equally poor service, and then tend to not use the benefit again. In this case, there is more at stake than wasted money. Employees and underwriting carriers might then be at risk for higher costs of care. Also important to HR staff is that dental plans that meet the needs of their employees mean less complaints for the department.
One dental plan, PacifiCare Dental and Vision, one of the largest managed care dental plans in the West, does provide information on care at the point of service. Specifically, information such as:
To give employers this kind of information, PacifiCare Dental and Vision introduced their Dental Practice Profile. In addition to being a tool for employers to measure over 60 different criteria that affect the soft side of care employees receive, the program is also designed to foster and support dentists in their practice management and to award dentists that provide compassionate care above and beyond their peers. Dental Health Maintenance Organizations (DHMOs) must seek to recruit and retain dentists that offer the best possible customer service and professional quality. In turn, dentists appreciate the feedback they get from the dental plan about their patients' perspective on their treatment and care. Under programs such as this, they are treated as the valuable and important partners they are which makes them more likely to stay in the dental HMO network and continue to provide and improve on quality care. This translates into stable care for employees.
The top performing dentists, besides being recognized, are rewarded monetarily, further highlighting the value and importance of their role to the plan, employers and employees.
The result of this kind of program, combined with the traditional measurement of education, experience, etc., create dental benefit programs that give employers the best indicators of quality and ultimately provide better value to employers, employees and dentists.
The company is based in Anaheim, Calif., and may be reached at 800-622-6388 or at www.pacificare.com/dentalvision.
Lee J. Harris, DDS, is vice president and chief dental officer for PacifiCare Dental & Vision in Anaheim, Calif.
Experience of Employees at the Point of Service. Business and Health 2001;6.