Conventional wisdom holds that a large dental network can deliver appropriate access and cost savings for employers, but MetLife experts contend that other attributes can come into play on adding value to dental plans.
“While a large network is important with the access and potential savings it provides to employees, you should look beyond these numbers alone,” says Alan Hirschberg, vice president, MetLife Dental Products.
“It is important to know whether the network size and the negotiated fees with each dentist are actually driving value and savings for your company. To do this, take your network analysis to the next level by looking at the effective discount, which takes into account a network's level of discounts and how often they're used.”
To help employers achieve this goal, MetLife recently issued a publication, titled
MetLife analysts assert that it’s “important for benefits managers to take their network analyses further to understand how the needs and behaviors of their employees align with how carriers balance network size, negotiated fees and utilization for effective discounts.”
For example, when determining the size of the network, employers need to realize that size comparisons may overshadow differences on counting methodology, file maintenance and utilization of dentists in the network.
Hirschberg points out that there is no industry standard for counting network dentists. As a result, he emphasizes the importance of understanding what the numbers represent, and to consider if a dentist has significant patient volume or capacity for growth.
The publication also provides insight on comparing negotiated fees under a multiple-provider network. Experts advise employers to look beyond the basic numbers to understand if and how the negotiated fees drive the dental plan’s value and savings.
In analyzing dental-provider networks, employers have to ask “what are fees based on?” and “is the same denominator being used when comparing different networks?”
The questioning shouldn’t just stop with negotiated fees. Employers also have to understand what’s driving effective discounts. That means finding out whether the network provides good access and strong negotiated fees because its utilization is weak due to other factors, such as plan design. Benefits managers should also investigate whether growing the network in certain areas will increase or decrease effective discounts.
"Obviously, it is important to have a dental network that offers employees choice and location convenience, but there are many other criteria to evaluate in order to optimize plan value and employee savings and satisfaction. Like many big purchase decisions, it pays to ‘check the label’ upfront," adds Hirschberg.
