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Dental Trends for 2024

January 31, 2024

We asked the dental insurance experts at the ADA for examples of what dentists should be ready for in the near future. They gave us these eight examples of what may be coming soon.

1) Artificial Intelligence – Payers may use radiographs to look for duplicate submissions. The potential of dental AI may be used to improve payer-provider relations, streamline claims review and ultimately provide an improved patient experience.

2) Some payers are expanding the use of the rollover of unused patient maximum benefits to the next plan year.

3) Some plans allow extra cleanings for patients with certain medical conditions. For example, one payer provides full coverage for one additional dental cleaning during pregnancy.

4) The value-based care (VBC) delivery model rewards providers for quality health outcomes rather than the quantity of care delivered. In this approach, providers focus on improving the health of a population of patients by offering care that is focused on prevention, best evidence and personalization. This shift allows care teams to maximize “chair time” and productivity, and the industry to better integrate with the overall health care system. Payors are starting to move away from the outdated fee-for-service model and toward alternative value-based payment models, such as capitation or global payment, bonus and incentive payments and shared savings models with or without shared risk. Some payers are starting to offer VBC programs.

5) Some payers are expanding preventive and diagnostic services not being deducted from the member’s annual maximum. Services like cleanings, exams, X-rays and sealants may not count towards members’ annual maximums.

6) States are starting to pass legislation which requires certain financial reporting and authorizes insurance commissioners to approve or disapprove plan premium increases.

7) An exclusive provider organization (EPO) is a managed care health plan that covers the cost of services from a closed network of care providers and these plans are growing in popularity with plan purchasers (employer groups). EPO plans cover services from the providers in a dental network, but won’t typically pay for care outside of it (except for emergencies).

8) Dentist Rating Programs

  • One dental plan uses a Brighter rating which connects patients, providers and payers. Patients have access to network dentist profiles and reviews. Brighter score consists of professional history, patient experience and affordability. Score of 1-10. Dentists can opt out of Brighter.
  • Another plan uses DentaQual ratings provided by Fluent. DentaQual is a ratings system developed by Fluent Dental Strategies that showcases the quality of the care provided to patients by providing a comprehensive, uniform metric. The DentaQual score appears on the dentist directory listing and is updated monthly.