How to Improve Patient Outcomes by Providing Supplemental Health Benefits

Date: 11/19/20

Around 40% of members skip recommended medical checkups and procedures due to high costs and limited coverage. While most health plans offer core benefits that address primary care visits and pharmaceutical coverage, there’s still a gap when it comes to vision and dental benefits. Supplemental health benefits such as these — along with access to additional resources like nurse advice lines and medication adherence programs — are necessary for improving members’ overall health.

Vision and dental may, at first, appear to be more quality-of-life concerns than critical care, but a growing body of evidence links these areas to chronic diseases, ranging from heart disease to cancer to diabetes to other serious conditions. What’s more, regular vision and dental checkups can help promote overall healthier habits and behaviors, leading to improved population health and lower healthcare costs.

Why Members Need Dental Benefits

When members stick to a routine of preventive dental healthcare exams, they’re more likely to be diligent in other aspects of their health and well-being. In addition, regular visits to the dentist can be a key factor in detecting potentially serious health concerns, including chronic diseases, and developing a care plan to address them early.

Unfortunately, routine dental visits aren’t as common as they should be, especially among senior members. According to a study on oral health and aging, about half of all seniors in the U.S. don’t visit the dentist, yet 53% have moderate to severe periodontal disease, which is a significant risk factor in most chronic inflammatory conditions.

As senior members’ oral health deteriorates, compounding dental problems contribute to poor outcomes and exorbitant healthcare costs. A study of emergency department visits in the U.S. revealed that dental-related emergency visits just about doubled between 2000 and 2010, from 1.1 million to 2.1 million, and the trend has continued.

For most senior members, the costs of care are the most significant deterrent. The study on oral health and aging also reported that 70% of older members lack dental benefits. Providing dental benefits to all members can help eliminate cost concerns for most of your senior population and encourage seniors to engage in better whole-health care routines.

Members Need Vision Benefits, Too

Giving senior members dental benefits contributes to the improved state of their overall health, but vision health is also a frequently overlooked aspect of holistic care. Other chronic health concerns (including diabetes, cardiovascular disease, chronic aches and pains, depression, and more) often accompany poor vision and vision loss.

Many vision problems are preventable, but vision care is typically as porous for senior members as dental care. A report from the National Academies of Sciences, Engineering, and Medicine shows up to 16 million Americans have vision errors that could be fixed with the appropriate intervention (glasses, contacts, or surgery).

Receiving that intervention isn’t possible for senior members who lack vision benefits. As a result, the cumulative impact of preventable and treatable vision concerns continues to rise. One CDC study shows the economic impact equates to $35.4 billion, including direct medical costs, additional treatment costs, and lost productivity.

For managed care organizations, providing supplemental dental and vision benefits is a win-win. It promotes healthier habits and diligent prevention in members while giving them access to the care that further improves their health outcomes. Additional resources such as nurse advice lines and medication adherence programs can add to this, giving members more avenues for staying informed and on top of their treatment. Supplemental care can help dramatically lower the costs associated with whole-person healthcare.

To learn more about how to improve member outcomes and how to control healthcare costs through supplemental health benefits, download our whitepaper, Why Members Switch Health Plans and What Plans Can Do to Keep Them.