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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

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

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

Growth Trends Continue in Vision Networks

Posted by Laura McMullen on Thu, Jan 12, 2017

Each year, we analyze the vision network data in our database and publish the results. Take a look at what we learned last year. Like 2015, 2016 brought growth across the board in the 10 largest vision networks: more providers in more networks that look more alike.

top 10 vision 2016.jpgOver five years, access points grew the most, 50%, followed by unique providers at 32% and unique locations at 13%. Two possible reasons for the lag in location growth is that retail locations, such as big-box stores and wholesale clubs, offer more revenue with fewer providers and online options to fulfill eyeglass and contact lens prescriptions are increasing.

The average number of locations per provider remained about the same year over year – 2.36 vs. 2.32. This is probably a reflection of network consolidation: Superior Vision completed the integration of the Block Vision network late in 2016.

Another measure of growth that we’ve been tracking for several years is the number of networks the average provider participates in. On average, providers belonged to 3.6 networks in 2016, which is slightly down from 3.7 in 2015, and an increase of 17% in the last five years. Eye care providers (ECPs) belong to less than half the number of networks as dentists (8.3 networks in 2016) which is most likely another reflection of the consolidated nature of the vision market compared to the dental market.

vision per provider 2016.jpgThe final trend we analyze is the distribution of providers by the number of networks they participate in. In 2016, 35% of ECPs are in 4-6 networks while only 23% were in 2011. The shift from accepting 1-3 networks to 4-6 for ECPs leads to greater overlap between vision networks causing less disruption if employer groups opt to change networks.

How are these trends affecting your business? When you talk to ECPs, are they more interested in joining your network than they have been in the past? How are you maintaining the uniqueness of your network?

Tags: vision networks, vision market, practicing locations, Vision insurance

Focusing on vision networks

Posted by Laura McMullen on Tue, Jul 07, 2015

A few years ago, we published a whitepaper called Clearing Up the Vision Market. Since then, the demand for vision networks has increased significantly with the number of people who take a vision plan when it’s offered growing from 78% in 2012 to 83% in 2013 in a 2014 SHRM study on vision care, so we decided to take another look.

As of March 2015, there are 48,000 optical locations in the top 10 national vision networks. They fall into two categories: independent eye care professionals (ECPs) and retail chains.

  • ECPs are defined by VisionWatch as having three or fewer locations with an ophthalmologist, optometrist, an optician, or an optical retailer on site. Nearly all ECPs are small businesses.  According to a whitepaper sponsored by Vision Source, ECPs are typically single location operations with less than $1.5 million in annual revenue and 12 or fewer employees. They have been in practice on average for 20 years.
  • Retail chains have 4 or more locations and may or may not have an ophthalmologist or an optometrist on site. The best-known brands in this category are widely available, such as LensCrafters, Pearle Vision, Walmart, and Costco.

ECPs make up two-thirds of locations and 45% of market share while retail chains are the rest. A recent Bain and Company study shows the second most influential factor (after cost) in selecting a managed vision care plan is the retail network the plan provides. This helps explain why retail chains account for 55% of vision sales, with only one-third of the locations.

A Consolidating Market

In a recent Wall Street Journal blog post, Optometrists Catch FFL’s Eye, Thomas Puckett of merger and acquisition advisory firm HPC Puckett & Co., said “There aren’t many operators with over 100 locations, but there are quite a few independents with under 50 locations. It is logical for businesses to consolidate in a geographic area.”

Private equity firms are projecting that the number of retail outlets will drop by half over the next five years through consolidation. Investors are most interested in firms valued at $10 to $50 million and the expected growth from the Affordable Care Act and the aging US population makes the industry even more attractive.

Other Vision Network Trends

A recent review of the top 10 national vision networks in NetMinder found some interesting trends:

top_10_vision
  • Vision networks are growing. The number of unique providers in these networks grew about 8% annually from 2011 to 2015. Unique locations grew more slowly (3% annually) and access points grew more quickly (11% annually). This is most likely because retail chains, such as Pearl Vision or Lenscrafters, generate more revenue with fewer locations.
  • Some ECPs practice at many locations. On average, ECPs are listed in provider directories at 2.4 locations with a range of 1.6 to 3.2 locations. This could be the beginning of a trend toward overstated access in vision networks. We see about 25% access point inflation in dental PPO networks and have put a validation process in place using claim data to adjust counts. We are watching vision networks closely to see if a similar filter is needed. 
  • vision_networksECPs are joining more networks. In March 2011, the average ECP participated in 2.5 networks. By March 2015, that count was up to 3.7 networks. This shift is quite dramatic: five years ago 75% of eye care providers in these networks were in 1-3 networks and now only 53% are while 15% are in 7-10 networks.


Are you seeing these trends play out in your network? Are vision benefits in demand among your customers and their employees?

Tags: network providers, Affordable Care Act, optical retail, Vision insurance, healthcare benefits, Managed Care, employee benefits, vision networks, practicing locations, Vision

 

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