Last year, Massachusetts overwhelmingly passed a ballot initiative that would bring dental premiums more in line with healthcare insurance premiums by establishing a medical loss ratio to ensure patients can receive more value from the fees they pay. The measure requires the state’s carriers to spend at least 83% of premium dollars directly on patient care rather than administrative costs, salaries, and profits.
After it passed, the American Dental Association (ADA) lauded the initiative and contributed over $5 million to the Massachusetts Dental Care Providers for Better Dental Benefits campaign. ADA President George R. Shepley, DDS, said of the effort, “What you’ve done here in Massachusetts has set the stage for the rest of the country. You all are just setting a shining example of where we can go in our future endeavors in dental insurance reform and what we can do to help our patients.”
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Florian Hillen Florian Hillen is the founder and CEO of VideaHealth, an MIT spinout and leading dental-AI company working with leading DSOs, insurers, and other companies in the dental industry. Previously, he conducted research at the intersection of engineering and social science at MIT’s Institute for Data, Systems and Society and at Harvard Business School. […]
Dental care as preventive care
That the ballot measure was first created and financed by a group of dentists (the Committee on Dental Insurance Quality) shows providers understand how seriously the industry needs to prioritize patient care. It’s still early days, but there are, understandably, questions about how dentistry in Massachusetts will respond. Some fear the measure will lead more dentists to increase their prices, which is undoubtedly different from what the initiative intended and wouldn’t benefit overall patient care.
However, before we decry the potential pitfalls of this bill, we need to take a step back and acknowledge the most significant problem in dentistry today: that Americans in all corners of the country need better dental care. Until dentistry is considered a critical part of overall preventive care, the concern for overall patient health should far outweigh the fears of care cost to patients.
As of 2019, over a third of people didn’t visit the dentist. In a country where nearly half of the adults over 30 and 70% over 65 have periodontal disease, that signals a significant portion of the population does not get preventative dental care. Considering people with gum disease can face three times the risk of heart attack, stroke, or another serious cardiovascular event, it’s clear the most important aspect of preventive care is getting people who don’t go to the dentist, to go.
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When patients regularly attend doctor visits, it increases the likelihood of earlier-stage disease detection. That directly correlates to more affordable treatment plans, reducing costs and making care more accessible for all patients. People need to understand that going to the dentist is critical preventative care that is essential to maintaining their overall health. Dentists are not just specialists to be seen when you’re in terrible pain. They’re medical specialists there to help keep you healthy, just like any other doctor.
Closing care gaps with tech
Chronic diseases such as diabetes and cardiovascular disease can be detected (and treated) earlier with proper oral healthcare. Oral health is inextricably linked to overall health, yet this topic is discussed more in dental circles than healthcare circles. In an industry with the highest rate of misidentifying problems, technology, specifically artificial intelligence (AI), is ushering in a new era of transparency and efficiency.
AI is already starting to break down the artificial line separating dentistry and other forms of health care, just as more Americans are pushing for comprehensive oral and traditional medical care. When fully integrated, this technology can tangibly improve patients’ lives by improving early identification and intervention for oral diseases. It becomes evident that dentists and hygienists play a critical role in protecting whole-body health when you examine the stream of data showing a correlation between poor oral health and chronic conditions.
Driving value-based dentistry with AI
If value-based care (VBC) aims to reward providers for quality health outcomes, technology that can promote early identification and intervention for oral diseases is essential to this care delivery model. In particular, the mainstream adoption of dental AI is critical for medical-dental integration (MDI) because it makes it much easier for dentists and doctors alike to identify chronic diseases.
Value-based care in dentistry should help providers focus on improving patient health through personalized, preventative care. Making this a reality requires technology that can quickly access patient and health data at scale. Introducing AI during clinical visits enables dentists to make treatment recommendations backed up by highly accurate analysis pulled from hundreds of millions of data points. Realizing value-based care is a matter of pairing AI with the deep experience of oral health professionals. This ensures the most accurate diagnoses while reducing treatment plan errors.
A step forward
The bill that passed in Massachusetts has tangible value to in-state patients by forcing payers to invest more in care. While it’s only one state, it’s a hugely positive first step and is establishing an important narrative: dentists and their patients want more transparency and for care to be better.
But the real obstacle that the medical world needs to focus on is medical-dental integration and removing barriers between oral and total body healthcare. To positively impact the health of the most significant number of people, dentistry must be amplified by AI and truly become preventive care. Meeting our most vulnerable populations’ oral health needs and associated chronic diseases should be priority number one.
Photo: PeopleImages, Getty Images
Florian Hillen is the founder and CEO of VideaHealth, an MIT spinout and leading dental-AI company working with leading DSOs, insurers, and other companies in the dental industry. Previously, he conducted research at the intersection of engineering and social science at MIT’s Institute for Data, Systems and Society and at Harvard Business School. He also worked for McKinsey & Company and founded Ninu, a digital healthtech startup. He holds two master’s degrees from MIT in computer science and technology policy and a bachelor’s in management and technology. He completed the first German State exam in medicine, as well.
