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The NetMinder Blog

The Provider Directory is a Valuable Marketing Tool

Posted by Susan Donegan on Fri, Aug 25, 2017

A dental provider directory can be a valuable marketing tool for a dental plan. A large provider directory means more access to care for the members of the plan. And the conventional wisdom is the larger the directory the better.

dental-networks-over-stated.pngA provider directory grows in two ways:

  • by adding providers (dentists), and
  • by adding provider locations (places the dentist practices at).

The combination of providers (dentists) and all the locations they practice at is commonly referred to as access points, or provider/location combinations where a member can “access” care.  

The Industry Is Concerned That Access Is Overstated

One of the concerns in the industry regarding the access points counting method is that providers are being listed at more locations than they actually do or can practice at. This phenomenon is due to a few factors. First, just the like rest of us, dentists retire, sell their practices, or die. Second, associate dentists (employees) tend to move from practice to practice. In both of these situations, it is difficult for dental plans to stay on top of this information, and there may be a significant lag when updating provider directories.

Finally, and most importantly, large dental groups with multiple offices ofen require that dental carriers list all of their dentists at all of their locations, even though they may only regularly practice at 2 or 3 locations. This is so that they can easily move dentists around without disrupting claims payment from the carriers. There are more than 1,300 dental groups nationwide with 5 or more locations, with the average group having 13.7 locations, resulting in overstated access in provider directories. (NetMinder, March 2011) 

Download our whitepaper,  Are Dental Provider Directories Overstated?  to learn more about using "practicing" locations to get a better picture of network access.

Tags: dentists, practicing locations, dental plans, provider directories, network access, access points

Healthcare Jobs Continue To Be The Best Jobs

Posted by Laura McMullen on Thu, Apr 13, 2017

The 2017 U.S. News & World Report rankings of the best jobs in the US are out and 8 of the top 10 are healthcare providers. Dentists are back on top after slipping to second after orthodontists in 2016; anesthesiologists and psychiatrists fell out of the top 10. Nurse practitioners moved up the most spots (from sixth to second) and orthodontists moved down the most (from first to fifth).  

Here’s the Top 10:  

best jobs_table.jpg(Statistician was fourth and computer systems analyst ranked eighth to round out the Top 10. Click here for the whole list.)

Healthcare jobs have dominated the top 10 for the last few years with solid demand, high job satisfaction, and strong salaries. Like last year, dentists, nurse practitioners, and physician assistants make up the clear majority of the projected demand. All three are generalists who offer treatment to people of a variety of ages on a routine basis. The rest of the providers in the list are specialists who provide care for people with specific needs.  

NetMinder Shows More Specialists Are Joining Networks

Generalists are in higher demand with more open positions overall. Interestingly, NetMinder shows that generalists are being added to provider networks more slowly than specialists.  

  • The number of general dentists who participate in national provider networks grew 11% between March 2016 and March 2017 while dental specialists grew 24% in the same period. 
  • The number of primary care physicians in broad, national networks grew 11% during the same period while specialists grew 15%.  

Two possible reasons for this are (1) specialty care costs more so carriers are motivated to add specialists to their networks and (2) there are more specialists than generalists. Medical networks are more mature than dental networks, which explains the slower growth rate of medical specialists in networks. 

The overall demand reflects the increased need for healthcare services in the US. Factors contributing to this need are: 

  • The aging of the US population. By the year 2040, about 22% of the population will be over age 65, per the US Administration on Aging. And we’re living longer: the Census Bureau reports that the average time to live for those turning 85 increased from 5.5 years in 1972 to 6.5 years in 2010. 
  • The shortage of doctors and nurses. Rigorous, lengthy, and expensive training requirements and the aging of the workforce plus unsatisfactory working conditions make these professions less attractive to young people. Some shortages result from faulty geographic and specialty distribution of healthcare professionals.  

While the greater demand for generalists is in line with the triple aim of the Institute for Healthcare Improvement: improve the patient experience (including quality and satisfaction), improve the health of populations, and reduce the per capita cost of health care, the shortage of specialists is also being felt. 

Demand For Specialized Healthcare Providers Small But Significant 

As we’ve seen in other years, the absolute number of professionals needed in these specialty fields is low, i.e. orthodontists, oral surgeons, and nurse anesthetists. Yet, the demand represents a significant percentage of the workforce and the training programs are long and rigorous requiring long lead times to fill openings. Many of these professionals serve limited populations during occasional periods with time-consuming or high-risk services which also suppresses demand resulting in a few openings with high rewards.  

All eight have similar satisfaction rankings and unemployment rates with the major differences in demand and salary possibilities. As in past years, the rankings take compensation, flexibility, opportunities for advancement, market demand, amount of stress, and skills or training required into consideration. See the methodology here

How are you addressing these supply and demand trends in your network development plans? 

Tags: Medical, dentists, network development, best jobs, healthcare providers, medical specialties, healthcare jobs

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

Best jobs in the US are health care providers

Posted by Laura McMullen on Tue, Feb 10, 2015

US News and World Report released its 2015 list of the 100 best jobs in the US and just like in 2013, dentists have come out on top. It’s not surprising since there continues to be strong demand for dentists, salaries are high, and current dentists report high job satisfaction. What’s new this year is that other health care providers have joined dentists at the top of the list.

All seven health care jobs have similar rankings and unemployment rates with differences in levels of demand and salary possibilities. Click here to learn more about the methodology US News used.

USNews_Graphic-1

(In case you are curious, the other three jobs in the top 10 are software developer, computer systems analyst, and information security analyst. See the rest of the top 100 here.)

The high demand numbers and low unemployment rates for these jobs are not news to anyone who has been paying attention to the healthcare industry recently. In fact, the Health Resources and Services Administration within the US Department of Health and Human Services predicts a shortage of 20,400 primary care physicians by 2020, if the system for delivering primary care stays the way it is, in their 2013 report Projecting Supply and Demand for Primary Care Practitioners through 2020. According to their estimates, even with nurse practitioners and physician assistants integrated into the delivery system, the national shortages will become less acute although supply and demand will vary regionally.

Publicity like the US News list and other media coverage of the employment outlook in healthcare highlights the good news and bad news for insurers, employers, and consumers:

  • As more people enter these fields, everyone will benefit from more choice in providers in the long run.
  • According to the American Dental Association 2010 Survey of Dental Practice, solo practitioners make up about 59% of all dental practices. While this number has declined from a high of 67% in 1991 according to a study in the Journal of Dental Education in August 2012, dentists and dental hygienists are still likely to start or join private practices which will increase the number of access points in dental networks
  • Physicians, registered nurses, nurse practitioners, physician assistants, and physical therapists tend to join large practices or work in hospitals or other facilities because medical practices are more likely to be set up as corporations for tax and liability protection. Therefore, fewer access points will be added to medical networks but there will be more providers at many locations.
  • Start-up costs are high and training timelines are long so we will likely experience shortages on the way to more choice. Nurse practitioner training tuition costs range from $22,500 to $45,000 depending on the program and takes between 12 and 18 months. Physician assistant training is approximately twice the cost and twice the time. The cost of nurse practitioner and physician assistant training is comparable but the time commitment is just a fraction compared to the cost and timing of physician training: $35,000 to $55,000 depending on the school and four years plus three to seven more for residency at a minimum. Other considerations are the number of seats in nursing and medical training programs and the number of qualified applicants.

In general, supply and demand for healthcare providers are not in sync. It’s clear the US population will continue to age and grow. How are you addressing these needs in your network development plans?

Tags: health insurance, network management, dentists, health care providers, network development

NetMinder Data Reveals Dental PPO Network Trends

Posted by Aaron Groffman on Thu, Oct 03, 2013

 

Size is one of the key ways to measure network strength, and the latest NetMinder data reveals that dental network size continues to increase.

There are two ways that networks generally grow:

  • Organic growth through direct contracts with the dentists themselves
  • Partnerships, leases and reciprocal arrangements

We see a clear trend that indicates both are happening. More networks are partnering, and dentists are joining more and more networks.

Dental Network Trends NetMinder Aug2013 resized 600Out of the top 15 national dental PPOS, 13 have one or more partners, according to our data. More than half have three or more lease partners, and the partners are not limited to traditional rental networks. Even carriers are offering some or all of their contracted providers in partnership arrangements.

Additionally, dentists continue to join more networks. From March 2009 to March 2013, the average number of networks per dentist in the top 15 networks grew from 6.2 to 7.4. Now 37% of dentists are in 11-15 networks, compared to just 26% of dentists participating with that many networks in 2009. By contrast, the
number of dentists in one to five networks shrunk from 55% to 46%.

Part of this increase can be attributed to the multiplier effect. When a dentist joins a lease network, he or she ends up in many networks.

I’m going to be diving even deeper into the data in the coming weeks, so stay tuned for more dental PPO network trends!

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

As Dental PPO Penetration Increases, Is Market Saturation Near?

Posted by Aaron Groffman on Fri, Nov 30, 2012

Our analysis of the top 15 dental PPO networks revealed another important trend: market penetration is growing, with room for more growth in the future.

Dental PPO market penetration (contracted providers as a percent of the available number of providers) continues to grow. As of March 2012, the average national PPO plan contracted with approximately 72,000 providers, representing 37.8% of available providers, up from 37.2% a year prior. By comparison, in 2008, market penetration was only 28.1%, with fewer than 50,000 providers contracted. The recent growth seems due in part to an increase in the number of networks dentists are joining.  Networks per provider increased from 5.9 in 2008 to 8.4 in March 2012.

Of course, there’s still plenty of room for growth. With nearly 120,000 providers, on average, not yet participating, we expect dental PPO market penetration to continue to increase.

 DentalPPOTrends MarketPenetration Netminder1 resized 600

Tags: network growth, dental, dental insurance, dental PPO networks, dental benefits, dental insurer, dentists, dental provider

Is Growth of Dental PPO Networks Sustainable?

Posted by Aaron Groffman on Fri, Nov 16, 2012

We recently analyzed the top 15 dental PPO networks and discovered several important trends in the dental PPO market. One of the most notable trends is that, so far, dental PPO networks continue to grow.

More dentists are contracting each year. In March 2012, the average national dental PPO network[1] contracted with more than 72,000 unique dentists, up 8.7% from the prior year. Additionally, reported access points increased 22%, much faster than the growth in unique dentists. Based on these two factors, on average, the number of locations a dentist practiced at grew from just over 2 in 2011 to 2.25 in 2012.

We’ve heard concerns that some network directories might be overstating access, so we dug deeper into the claims data provided by many of our clients.  We found that, of the average 2.25 locations per dentist that directories claim, we were able to confirm an average of 1.34 practicing locations.  A practicing location is one where there was confirmed claims activity for the dentist during the last twelve months.  As we receive more and more claims data from clients, the number of practicing locations will most likely increase.

With all this growth of dental PPO networks in recent years, we have to ask: is it sustainable?


[1] The average of the top 15 national dental PPO networks.

Tags: network growth, dental, dental insurance, dental benefits, dental insurer, dentists, dental provider

 

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