network data is useful. netminder knowledge is powerful.

The NetMinder Blog

Synergies Helping the Dental and Vision Insurance Markets Work Together

Posted by Susan Donegan on Fri, Jan 26, 2018

In dental and vision insurance, the network is where the consumer experience happens. That’s why it’s important to know the network landscape and leverage all points of differentiation and separation from the competition.

First, a few definitions. These observations are based on a review of NetMinder data for the top 15 national dental PPO networks and the top 10 vision networks as of March 2015. A network is defined as a payer/plan combination, i.e. Delta Dental PPO or EyeMed Access. Counting methods are:  

  • Access Points: each provider at each location in a provider directory.  
  • Unique Providers: each provider one time regardless of the number of locations s/he is listed at in a provider directory.
  • Locations: each location one time regardless of the number of providers who are listed there in a provider directory.

AvgNetworkSize.jpgRelatively speaking, dental networks are much larger than vision networks. The supply of dentists is larger than the supply of optometrists and ophthalmologists. There are 65 dental schools vs. 23 optometry schools23 and nine dental specialties vs. two optometric specialties.

There is also greater demand for dental services:

demand_dental_vision.jpg

Download our whitepaper to learn more about these favorable trends as well as the synergies that help the dental and vision insurance markets work together. 


23 https://en.wikipedia.org/wiki/List_of_dental_schools_in_the_United_States:
24https://www.quora.com/How-long-does-a-routine-dental-checkup-normally-take-in-the-U-S-if-the-patient-is-perfectlyhealthy-and-schedules-one-every-six-months
25http://www.webmd.com/eye-health/what-to-expect-checkup-eye-exam-adults#1
26 http://health.costhelper.com/teeth-cleaning.html
27 http://eyeexamcosts.com/understanding-eye-doctor-costs/

Tags: dental insurance, Vision insurance, vision networks, dental network, access points, unique providers, provider locations, practicing locations, NetMinder, network analysis, network comparison tool

Six Synergies That Make Selling Dental and Vision Plans Together Smart

Posted by Susan Donegan on Wed, Jul 19, 2017

Beyond their similar relationship to medical plans, dental and vision plans have several other synergies.

The same components are evaluated during the dental and vision benefits sales processes: benefit, price, and network. Both products have defined benefit structures that can be compared on specific points. Rates are presented in tiers based on job classifications and number of people covered. Networks are less complex than medical plans and specific tools and processes have evolved to compare apples to apples.

The same network analysis tools can be used for both products to differentiate between networks. The sales process requires size comparisons, accessibility measurements, overlap/disruption analysis, and sometimes re-pricing analysis. network analysis pyramid.jpg

Beyond the departments that all companies have such as IT and facilities management, dental and vision plans can share functions like pricing, sales, marketing, and underwriting. Many multiline carriers have shared sales forces that use a single point-of-contact as a selling advantage. There are also departments that perform similar functions like recruiting and credentialing, where process synergies can come into play.

And, distribution strategies, like whether or not to be on an exchange, broker marketing strategies, and voluntary/worksite programs, since both products are voluntary-friendly, can be leveraged across both lines of business.

Download our whitepaper,  Exploring How Dental and Vision Work Together to learn more about the synergies that help the dental and vision insurance markets work together. 

Tags: dental network, vision networks, health insurance, healthcare benefits

NetMinder's Data Brings Intelligence to Recruiting

Posted by Susan Donegan on Tue, Jun 27, 2017

NetMinder provides the data you need to recruit proactively. A shorter target list of the best prospects makes it easier to succeed, and less expensive to do so.

Here are just a few of the ways network managers can use real market intelligence to recruit proactively.

  • intelligent recruiting.jpgLearn which dentists participate in many networks. They'll be more receptive to adding new networks and can help you grow more efficiently.
  • Find locations with multiple dentists. This creates efficiency in increasing sheer numbers of dentists.
  • Find dentists who practice in more than one location. This makes it easier to increase listed locations, compared to recruiting one at a time.
  • Find dentists where you know they are practicing. Confirmed by submitted claims, practicing locations are your best place to find dentists to recruit.
  • Target dentists who are heavily utilized. Selecting those with more cliams activity helps you find the more popular dentists.
  • Look for dentists who accept discounts. Prospects who accept discounts from others should be more affordable.   

Download our whitepaper, Recruit Smarter, Not Harder to learn how NetMinder data can help you target and recruit dentists more successfully and efficiently.

Tags: insurance companies, dental network, practicing locations, claims data, Healthcare, insurance networks

A Peek At Dental and Vision Network Trends

Posted by Susan Donegan on Wed, Mar 29, 2017

In dental and vision insurance, the network is where the consumer experience happens. That’s why it’s important to know the network landscape and leverage all points of differentiation and separation from the competition.

First, a few definitions. These observations are based on a review of NetMinder data for the top 15 national dental PPO networks and the top 10 vision networks as of March 2015. A network is defined as a payer/plan combination, i.e. Delta Dental PPO or EyeMed Access. Counting methods are:  

  • Access Points: each provider at each location in a provider directory.  
  • Unique Providers: each provider one time regardless of the number of locations s/he is listed at in a provider directory.
  • Locations: each location one time regardless of the number of providers who are listed there in a provider directory.

AvgNetworkSize.jpgRelatively speaking, dental networks are much larger than vision networks. The supply of dentists is larger than the supply of optometrists and ophthalmologists. There are 65 dental schools vs. 23 optometry schools23 and nine dental specialties vs. two optometric specialties.

There is also greater demand for dental services:

demand_dental_vision.jpg

Download our whitepaper to learn more about these favorable trends as well as the synergies that help the dental and vision insurance markets work together. 


23 https://en.wikipedia.org/wiki/List_of_dental_schools_in_the_United_States:
24https://www.quora.com/How-long-does-a-routine-dental-checkup-normally-take-in-the-U-S-if-the-patient-is-perfectlyhealthy-and-schedules-one-every-six-months
25http://www.webmd.com/eye-health/what-to-expect-checkup-eye-exam-adults#1
26 http://health.costhelper.com/teeth-cleaning.html
27 http://eyeexamcosts.com/understanding-eye-doctor-costs/

Tags: dental network, vision networks, health insurance, counting method, dental provider, Vision insurance, practicing locations

Dental PPO Network Growth Rate Down While Locations Per Provider Increased Significantly

Posted by Laura McMullen on Mon, Oct 24, 2016

Our annual analysis of dental network trends showed overall annual growth in unique providers of ~7-8% over the last five years. By all measures, networks are growing.

Here’s the breakdown:

  • The average number of unique locations grew from 58K to 77K, or 33%
  • The average number of unique providers grew from 72K to 99K, or 37%
  • The average number of access points grew from 163K to 309K, or 90%

Top 15 Dental PPOs_mar 2016.jpgNot only are there more locations and more providers, but there are also more locations per provider: up 38% (2.25 to 3.12) from March 2012 to March 2016.

And yet, when we did this same analysis in 2015, we saw 10% annual growth in unique providers over the prior five years. While the growth was higher in access points and lower in unique locations like it is this year, all of the percentages were higher:

  • The average number of unique locations grew from 54K to 76K, or 41%
  • The average number of unique providers grew from 67K to 100K, or 50%
  • The average number of access points grew from 134K to 281K, or 110%

Interestingly, the average number of locations per provider only grew 29% (2.01 to 2.82) between March 2011 and March 2015.

So if the annual growth rate is lower, and the overall growth in each counting method is less, why did the average number of locations per provider grow 33%?

The multiplier effect we were starting to see in 2015 has blossomed. Just one of the 15 largest national dental PPO networks doesn’t have any lease partners and the other 14 have increasingly more complex network stacks. On average, the largest networks have four network partners and four networks have six partners. Connection Dental, DenteMax, Maverest, and Stratose are the most frequent network partners.

Another factor is the number of networks each dentist is joining. In our analysis, we found that the average dentist participates with 55% of the top 15 dental PPO networks, while nearly half of dentists in networks are in at least 11.

One more element of the growth is the rise of dental service organizations. We’ve seen a decade of private equity investment and that’s paying off. Becker’s Hospital Review noted that a 2014 Sageworks analysis found that DPMs generated the highest return on equity of the industries it examined. With additional cash, DSOs are growing by building and acquiring dental practice. And following the industry practice of listing each provider at each office contributes to the increase in locations per provider.

How are these trends playing out in your networks and markets? About 40% of dentists participate in 1-4 networks, so there is still room for organic growth. How well are both tactics represented in your strategic plan?

Tags: dental network, counting method, network providers, dental PPO networks, network growth

Dentists participating in more networks than ever

Posted by Laura McMullen on Thu, Jun 18, 2015

When we completed our annual review of dental PPO network trends based on the network data in NetMinder, two things really stood out:

  • The average dentist participates in 8 of the top 15 national dental PPO networks. 
  • Since March 2011, the number of dentists in more than 11 networks has grown by 15 percentage points.

dental_combo-1

The driving force behind these numbers seems to be the proliferation of lease and swap arrangements in the dental benefits industry. A dentist joins a network and then that network is leased to several other carriers so the dentist is now in multiple networks.

These arrangements enable rapid network growth by adding large groups of dentists at a time and make it easier to match competitors. In the past, dental benefits companies partnered with network leasing companies, such as DenteMax or PPO USA. Now we are seeing carriers swap networks like United Concordia and DNoA.

Maximizing the overlap between carriers is a sound strategy in a market where takeover business is predominant. Since the 2014 NADP State of The Dental Benefits Market study shows that 61% of Americans have dental insurance, this seems like the right strategy for right now.

How are these larger dental PPO networks playing out in your book of business?

Tags: dental network, network data, dental PPO networks, dental benefits, dentists

Five Best Practices to Find the Right Provider Network for Your Customers

Posted by Laura McMullen on Thu, Jul 24, 2014

In a recent blog post entitled, Five Best Practices to Use Network Data and To Grow Your Business, we wrote about the ways carriers and network leasing companies can improve their position in network comparisons by better cleaning their data. Another point of view is from the brokers and consultants who use network analyses to help their customers choose the right benefit plans.

health insurance plansShopping for employee benefits is complicated and time consuming. Employers and other plan sponsors typically rely on a broker or consultant to help them through it. Brokers and consultants know that network issues can turn a satisfied customer into one that goes out to bid in the blink of an eye. Even if everything else is right: price, benefits, service, and timely and accurate claims payments can’t outweigh a network that doesn’t fit the employee population.

As we pointed out in our other post, the best networks:

  • Offer a wide range of choices: multiple general and specialty providers are included in the network
  • Are convenient to use: providers are located near home or work
  • Include popular providers and facilities: providers are the ones that members and their families want to use
  • Save employers and employees money: in-network providers offer meaningful discounts that reduce out-of-pocket expenses and claim costs

Depending on the number of employees your customers have, different types of network analyses are probably available from your carrier partners. Generally, we see four types of network analysis:

  • Network Counting – measure the quantity of providers in each network (available for groups of all sizes)
  • Accessibility Analysis – correlate network provider locations to employee home and work locations (available for groups of all sizes)
  • Disruption Reporting – match historical provider utilization and claims experience for a group to the providers in a different network (available for groups with at least 200 employees)
  • Repricing – compare cost of claims for all providers (in- and out-of-network) if a different network were in place to the cost experienced in the current network (available for very large or self-funded groups)

Download our whitepaper, The Network Analysis Pyramid, to learn more about each method.

As the primary users of network analyses, brokers and consultants are in a unique position to influence the requirements of each type of analysis. Keep these five best practices in mind as you work with carriers on your customers’ behalf:

  1. Insist on clean, accurate data so you get clean, accurate reports.
  2. Clearly identify required fields and formats in all file requests.
  3. Obtain claim data from the incumbent carrier whenever possible.
  4. Choose a consistent counting method for all reports to ensure that you are comparing apples to apples.
  5. Evaluate key specialties separately from the overall network based on your client’s needs.

With all of the changes from the Affordable Care Act, employers and other plan sponsors are relying on brokers and consultants more than ever.

How do you evaluate networks today?


 

Tags: Healthcare, healthcare reform, Affordable Care Act, health insurance, health reform, data management, data analysis, network providers, health insurers, dental network, ACA, market comparison, network metrics, compare networks, healthcare exchanges, network comparison tool, network change, provider networks, disruption reporting

How the Affordable Care Act (ACA) is Influencing Adult Dental Insurance Coverage

Posted by Laura McMullen on Thu, May 15, 2014

Adult dental insurance is a hot topic thanks to the Affordable Care Act (ACA) and Healthcare.gov. Under the new healthcare law, dental coverage for children 18 and younger is considered an essential health benefit that must be included in all plans sold on exchanges. For adults, it’s a different story: insurers don’t have to offer adult dental coverage, nor do adults have to purchase it.

dentistsThis situation could lead to fewer healthy adults purchasing dental coverage because their health insurance budget is committed to the mandated ACA coverage. This effect may drive up dental premiums for everyone if the pool of prospective purchasers consists only of those needing more extensive and costly dental treatments. From a network perspective, dentists may find themselves joining more networks to fill in the gaps and gain new patients.

Nancy Smith lays out the ramifications of ACA on adult dental coverage and concerns from dentists in this Sunshine State News article “Obamacare Leaves Gaping Cavity in Adults’ Dental Health”.

Individual Adult Dental Insurance Plans

Consumers may start looking for individual adult dental insurance plans. This is an opportunity to promote a variety of dental plans, ranging from discount plans to stand-alone insurance plans to dental benefits that are embedded in qualified health plans on exchanges. These plans can differ significantly from traditional, employer-sponsored dental plans and may require education to ensure member satisfaction.

dentist toolsFor example, “annual maximum” is an important term when talking about adult dental insurance. The annual maximum, or benefit cap, limits the maximum amount the insurer has to pay, making the consumer responsible for any additional costs beyond the maximum. Due to ACA, new health insurance policies do not include a benefit cap. However, for consumers looking for both health and dental insurance, benefit caps can still exist in adult dental plans under the name “annual maximum.”

Read more on this topic in the article “What is the Problem with Adult Dental Insurance Plans on Healthcare.gov?” by Naomi Mannino on www.mainstreet.com. Of course, consumers should check that their providers are in the network.

Voluntary Group Plans

In some cases, another option is voluntary group dental insurance. Caitlin Bronson, in Insurance Business America, reports that some groups are dropping health insurance plans so that their employees can use the exchanges but adding voluntary ancillary benefits, like dental and vision plans. She writes, “Roughly 80% of voluntary sales are dental coverage, with a projected 2% increase in 2014, Towers Watson found in its 2013 Voluntary Benefits Survey.”

These plans allow employers to offer a popular benefit and pass the cost along to their employees via payroll deduction, which in some cases eases the sting of changes in health insurance benefits. Some believe that voluntary plans don’t offer enough coverage for the cost to satisfy commercial clients and their employees.

With several options to choose from, will healthy adults opt for dental coverage?  

Tags: dental benefits, dental insurance, dental insurer, health insurance, healthcare benefits, network providers, dental network, dental providers, ACA, Affordable Care Act, compare networks

All Provider Networks Are Not Created Equal

Posted by Aaron Groffman on Mon, Dec 23, 2013

Overlap between provider networks has emerged as an important metric in determining network strength.  NetMinder data on the top 15 national dental PPO networks shows that similarly sized networks can actually be quite different in terms of overlap, or how many providers they have in common.

Recruit Smarter, Not Harder whitepaper

Why is network overlap important? Here are three key reasons:

  • The dental benefits market is relatively flat. From 2002 to 2011, the percentage of the U.S. population with dental benefits has ranged between 54% and 58%.
  • Take-away business fuels dental plan growth.
  • Minimizing disruption for plan members is important if you want to take away business, and a higher rate of overlap with your competitors’ networks means less disruption.

Among the top 15 national dental PPO networks, the overlap in access points ranges from 39% to 68%, while the overlap in unique dentists ranges from 53% to 88%. 

The greater the overlap you have with as many networks as possible, the better positioned you are to take away business from your competitors.

Download our new whitepaper to learn how to “Recruit Smarter, Not Harder.”

Tags: dental insurance, network growth, dental PPO networks, network providers, dental network

Which Provider Counting Method Do You Prefer?

Posted by Aaron Groffman on Mon, Dec 09, 2013

I asked attendees at my recent NADP CONVERGE 2013 break-out session which counting method they prefer to use for comparing provider networks, and the majority answered “unique providers.”

Counting Methods in NetMinder Dental PPO Reports

Based on NetMinder user data (as illustrated in the chart), access points (each provider at each of their locations) is still used about half the time, but the unique providers counting method is catching up.  In 2012, 36.7% of NetMinder dental PPO reports used unique providers as the counting method, and 53.7% used access points. This year we started to see a shift, with 40.9% of reports using unique providers and 50.7% using access points.

It makes sense that unique providers would be the preferred counting method for NADP attendees, who tend to be senior level managers looking for a big picture view of how their company is performing. Using unique providers simplifies the equation because it means each provider is counted once regardless of how many locations he or she is listed at. This eliminates duplication caused by a) associates who change offices and b) providers who are listed at multiple locations to facilitate claim payment.  Looking at access points with an overlay of our exclusive practicing locations indicator offers a similar view to counting unique providers with the added benefit of including multiple locations that have been validated by claim activity.

Which counting method do you prefer and why?

Tags: network growth, network providers, dental network, dental providers

 

CONNECT WITH US

 

NetMinder delivers industry leading network comparison tools that make your sales force more effective and your recruiters more efficient. Network data is useful. NetMinder knowledge is powerful. Learn More About What We Do

 

RESOURCES