Building a stronger Broward County Government workforce, one smile at - - PowerPoint PPT Presentation
Building a stronger Broward County Government workforce, one smile at a April 2019 Proprietary Taking the journey with you Going Improving local health Meeting members where Helping members they are, when and how achieve better health
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April 2019
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Improving health
Helping members achieve better health at a lower cost
Making it simple
Making a complicated system easier to navigate
Leading the change
Offering innovative technology and member-centered benefits
Going local
Meeting members where they are, when and how they need us
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7 of the top 10 25 of the top 30 37 of the top 50 Top Providers General Dentists 98% Endo/Oral Surg/Ortho/Perio – 99% Geo Results
1 Internal network data.
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Teaming with Columbia and Harvard Universities
First to study the link between medical and dental Initial and ongoing dental- medical integration to study how dental care improves
Results include links between diabetes, heart disease, low birth weight babies to proper
Opioid Alternative First and only dental insurance company to study and offer
Dentists prescribe 12% of all immediate release opioid prescriptions The majority of dental prescriptions are to children ages 10-19 Exparel is a non-addictive,
surgical site that relieves pain for the first few days
Rush To Brush
Pneumonia is the #1 acquired infection in America Help patients combat hospital-acquired pneumonia (HAP) We will send ~36K care packages to members with upcoming surgeries
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What Aetna
Standalone dental carriers
identification and outreach
communications including mail, email and phone
increased
to medical claims
additional fee to implement
to error
Other integrated carriers
potential manual error
to self-report
channels for member
decrease lower improved
use of preventive use of basic and major medical costs1 diabetes control1 dental care1 services
1 Ongoing, statistically-valid analysis of Aetna DMI customers. Aetna Informatics. Proprietary
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Service Model
calls from Aetna members and provider are “warm” transferred for detailed coverage information
for Aetna medical and dental products
associated with oral surgery process
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percent on an eye exam and a pair of eyeglasses compared to someone without vision benefits.5
Account Executive
Wanda Crawford
Account Manager
Minerva Henry
Sales Support Consultant
Barry Noorigian
Dental Retention Manager
Alex Harkins, CEBS
Director of Sales
Renthia Jackson
Vice President of Sales,
Your team gets results
satisfaction1
responds quickly1
91%
customer retention2
Determine roles and responsibility Identify technical resources Set expectations Develop project plan Conduct status calls Finalize plan design Account structure and eligibility Systems setup Member services training Open enrollment communication Plan testing Load eligibility / enroll members Mail ID cards Evaluate implementation Project debrief Transition to account team
Discover Define Implement Plan setup Validate Post implementation
Collect information Form implementation team
Go live 1/1/2020
Pre-Effective Date Average Implementation $10,000 Implementation / service center available is 34 days Communication Budget for members included
1 APT Medical Member National Accounts Report Card 1Q – 4Q results. Results are based on a telephone survey of Aetna Medical Members – National Accounts conducted from February to November by DSS Research, a third-party market research vendor. Proprietary
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Our digital tools help members reduce out-of-pocket costs, better manage their family’s oral health and more easily connect with network providers
1 Source: 2018 internal data
are accessing the tool are searching for providers1
Search for cost-effective network dentists and decide based on dentist profiles and ratings, and patient reviews Schedule appointments online Receive email reminders to schedule dental visits and take care of oral health Compare out-of-pocket costs for any service, like a filling or X-ray. Cost is calculated using provider’s fee and applying member’s cost share, deductible and annual maximum
Aetna Navigator
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Search by condition, location, provider name, etc. See how many colleagues visit this provider Get estimated procedure costs View dentist rating which takes into account professional history, affordability, patient experience, etc.
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vary throughout the proposals that there were exceptions and how they would impact county employees
questionnaire section of the RFP
based on frequency limits
employees as well.
providers
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