Vision and dental benefits can be harnessed to play a larger role in employee health than the sum of their parts. Thats due in part to the fact that many people find visiting a medical doctor intimidating, but have no qualms about having an eye exam or dental check-up and cleaning.
The mouth is the gateway to the body, dentist Michael D. Weitzner reminded a webinar audience recently. As a result, basic oral exams performed by dental professionals can lead to detection and treatment of several non-dental conditions, he added.
Dr. Weitzner, vice president, national clinical operations at UnitedHealthcare Specialty Benefits, told an audience of benefit decision-makers he has observed a growing recognition that specialty care plays a larger role in overall patient care or at least can play a larger role if benefit designs, backed up by a strong communication effort, facilitate that synergy.
That perspective was shared by co-presenter Jonathan Ormsby, a strategic account manager for Transitions Optical. The pair tackled the topic of wellness and disease management through dental and vision at a webinar sponsored by Davis Vision, Employee Benefit News and Employee Benefit Adviser.
Spotting systemic disease
Many systemic diseases are visible by looking into the eye, even before symptoms are evident, Ormsby said. The primary examples are hypertension and prediabetes. An eye exam services as an introduction to the medical system for people who consider it less intimidating than even a routine physical assessment, he added.
When an optometrist or ophthalmologist identifies a prediabetic condition early, the opportunity is created for the patient to be led to a different lifestyle path that could prevent the development of disease.
Also, the impact of routine vision problems on employee productivity should not be lost in the consideration of purely medical issues. Even slightly miscorrected vision, Ormsby said, can reduce productivity by up to 20%.
For their part, dentists are equipped to detect systemic infections through periodontal exams. They also are attuned to diabetes, as one-fifth of all cases of tooth loss are attributable to diabetes, according to Weitzner.
Also see: Employees set sights on vision insurance
Treating gum disease can also reduce high inflammation levels that can have a negative ripple effect on other conditions, he said.
Integrated delivery model
Components of an integrated health care delivery model that leverages dental and vision providers services as envisioned by UnitedHealthcare include cross-discipline clinical programs and services, enhanced communication, integrated reporting, health care analytics, a comprehensive view of patient engagement, predictive modeling, shared technologies and savings opportunities.
Another element is enhanced benefits according to risk factors that vary from one employee to the next. That can mean, for example, providing 100% coverage for preventive and periodontal care for pregnant women both during their pregnancy and three months afterwards.
It all starts with prevention, Weitzner said. Plan designs that serve as barriers to preventive diagnostic procedures, including co-pays, are discouraged.
Save the co-pays for the expensive procedures, he added.
But even reducing cost barriers does not guarantee employees will take advantage of dental and vision benefits. According to Ormsby, 22% of employees offered vision benefits do not enroll, and only 20% of those who do enroll use the benefit to pay for an annual eye exam.
Aggressive efforts to engage employees not only on the existence of the benefits, but the importance of their utilization, must be maintained, Ormsby said.
Richard Stolz is a freelance writer based in Rockville, Maryland.
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