The needs and wants of Canadian employers for healthcare benefits are surely changing. Now, it is all about managing chronic diseases such as hypertension, diabetes, arthritis and obesity. The days of offering a simple drug plan so that employees could take pills for these ongoing problems are long gone. Employers and their insurers are getting involved — because they have to. The costs of benign neglect are now too prohibitive.

So says a recent report in Benefits Canada. I observed this shift by insurers to more active involvement in the health of the employees in a recent meeting of Green Shield. The presentation was all about “health for life”, and the focus was getting better adherence to medications. So the dawn of activism in group health benefits has arrived.

So what does this mean to the most common chronic disease for Canadian employers — dental decay?

Traditionally, insurers have taken an administrative approach to containing costs of dental care. They have introduced co-pays, increased deductibles and excluded certain procedures.

And to little effect. Group dental costs continue to rise, in many cases significantly faster than inflation and more so than the drug plan.

So the next step by leading insurers is to look deeper at why dental costs are now problematic. They are finding a number of key patterns:

  • dental costs are largely clustered amongst a minority of employees
  • these employees are chronically needing expensive dental care
  • there are no observable improvements in the oral health of these high risk employees
  • many of these same employees are also big spenders on medications for other chronic diseases.

So what is to be done? Target more preventive care to those who are chronically sick with cavities and crowns, or with periodontal disease. And then measure the outcomes.

Employers need and want change in their healthcare benefits, including dental care. Insurers are responding. And so too must the dental practice.

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