City of Los Angeles 2018 Annual Dental Review September 5, 2019 - - PowerPoint PPT Presentation

City of Los Angeles 2018 Annual Dental Review

September 5, 2019

2018 Summary of Activities

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Key ey A Activi vities es Fut Future A Activ ivities Dental l Utiliz izatio ion

 Healthy Teeth, Healthy Body Webinar  Preventive Care Seminars  Open Enrollment Seminars  Onsite Dentist at Wellness Festival  Enhanced Website  Increased PPO utilization contributed to lower plan costs in 2018  Shift from high risk to low risk enrollees  Decrease in cleaning utilization for employees & members  Increased website utilization  Exploring digital promotional campaigns  Enhancing benefits to include coverage for posterior composite fillings  Continued support of City’s wellness initiatives

Enrollment Snapshot

16,787 545 8,209 17,057 556 8,513 5,000 10,000 15,000 20,000

PPO Plan Preventive Plan DHMO Plan

Primary Enrollees

2017 2018

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48.8 47.0 43.5 46.6 50.0 47.2 46.0 49.2 15.0 13.6 14.0 12.5

0.0 10.0 20.0 30.0 40.0 50.0 60.0

PPO Preventive DHMO Benchmark 2018 Average Member Age Primary EE Spouse/DP Child

Enrollment Change  PPO: +1.6%  Preventive: + 2.0%  DCUSA: + 3.7% Average Contract Size* % Change  PPO: -1.7%  Preventive: -1.3%  DCUSA: - 2.3%

2017 2018 Plan EE Members Average Contract Size* EE Members Average Contract Size* PPO 16,787 37,891 2.257 17,057 37,830 2.218 Preventive 545 749 1.374 556 754 1.356 DHMO 8,209 17,008 2.072 8,513 17,239 2.025

*Average Contract Size – Ratio of total covered Members divided total covered Employees ** Benchmark data throughout this presentation is Delta Dental’s overall Book of Business, except where otherwise noted.

PPO Financials & Savings

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34.2% 35.3% 36.1% 14.7% 16.7% 16.3% 27.5% 28.8% 29.6%

0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0%

2016 2017 2018

Network Savings PPO Premier Net effective discount

5.4% 5.2% 5.5% 30.2% 29.6% 28.6% 64.4% 65.2% 65.9%

0.0% 20.0% 40.0% 60.0% 80.0% 100.0% 2016 2017 2018 Network Utilization Non-contracted Premier PPO

2.0% decrease in total claim costs, 3.5% decrease on a PEPM basis  Decrease in contract size  Steady growth in PPO Utilization  Increase in network savings

$25.00 $35.00 $45.00 $55.00 $65.00 $75.00 $85.00 2015 2016 2017 2018

$79.64 $75.77 $80.37 $77.53

PEPM Claims

PPO Dentist : In-network provider who agrees to lowest discounted fees and contractual guidelines Premier Dentist: Providers in Delta Dental’s secondary network that have agreed to discounted fees and contractual guidelines Non-contracted Dentist: Out-of-network provider that has not agreed to discount fees

PPO Risk Trends: Year Over Year

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 High Risk members are trending to Low Risk over the last 3 years.

Any enrollee that has been in the plan more than a calendar year, visited the dentist in that time and not presented with any oral risk factors and/or received a caries risk assessment code of D0601, low risk. Any enrollee that has:

• Had any periodontal visits or root canals in the last 3 years
• Received 3 or more restorations in the last 3 years, 2 or more restorations in the last 2 years, or one or more

restorations in the last year

• Received caries risk assessment of medium or high from their dentist.

Any enrollee that has been enrolled for more than a calendar year without any visits to the dentist in the most recent calendar year. Any enrollee that has been enrolled for less than one calendar year, that does not meet high risk criteria.

Wellness Objectives

6 GOALS:  Increase # of employees receiving preventive care  Increase the # of employees visiting dentists RESULTS:  Minimal changes in employee utilization  0.2% decrease in # of exams  1.0% decrease in # of cleaning  0.4% increase in # of employees not visiting a dentist

EMPLOYEES

Period

Avg. # EE’s No Visits Exams Cleaning 2017 17,332 5,989 34.6% 11,253 64.9% 10,641 61.4% 2018 17,613 6,172 35.0% 11,397 64.7% 10,637 60.4%

PPO and Preventive Plans

Wellness Objectives

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*Delta Dental’s benchmark data is based on member’s who have been eligible for at least 12 months

PPO and Preventive Plans

DELTA DENTAL BENCHMARK*

• No Visits – 21.4%
• Exams – 62.4%
• Cleaning – 64.5%

Members Eligible for 12+ months

Period

Members No Visits Exams Cleaning 2017 38,363 8,802 22.9% 23,347 60.9% 22,691 61.0% 2018 38,085 8,828 23.2% 23,304 61.2% 22, 446 60.7%

OPPORTUNITIES TO IMPROVE UTILIZATION:  Target new hires and non-users  Digital campaigns  Explore partnering opportunities with Limeade  Continued participation in City’s wellness program OBSERVATIONS:  Continued promotion of the City’s wellness objectives should contribute to closing utilization gaps between the City and Delta Dental’s benchmarks

48. 48.3% 22. 22.2% 10. 10.2% 1.1% 1% 7.3% 3% 2.7% 7% 2.5% 5% 3.9% 9% 0.4% 4% 0.8% 8% 46.5% 27.3% 9.3% 0.9% 5.7% 2.5% 2.7% 3.7% 0.3% 0.6% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0%

2018 Benchmark

Utilization by Category

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PPO PPO Pl Plan n (exclud ludes P Preventive Pl Plan) n)

Classification 2017 2018 Benchmark +/-

Diagnostic & Preventive 70.4% 70.5% 73.8% Basic 23.8% 23.8% 21.1% Major 5.7% 5.8% 5.1%

2018 Distribution by # of Procedures

Diagnostic & Preventive Basic Services Major Services

 Closing care gaps (i.e., increased utilization of preventive services) could mitigate the financial impact associated with major services

57.3% 14.1% 5.4 .4% 1.9 .9% 9.7 .7% 2.7 .7% 3.2 .2% 0.2 .2% 0.4 .4% 52.3% 17.9% 6.2% 1.7% 8.4% 3.9% 4.0% 0.4% 0.5% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0%

2018 Benchmark

Utilization by Category

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DHMO

Classification 2017 2018 Benchmark +/- Diagnostic & Preventive 69.2% 71.4% 70.2% Basic 26.9% 24.8% 24.9% Major 3.9% 3.8% 5.0%

2018 Distribution by # of Procedures

Diagnostic & Preventive Basic Services Major Services

 Member utilization trends compare favorably with Delta Dental’s DCUSA Book of Business benchmarks

ID Card 3,468 Benefits 6,956 Claims 4,401 Documents 3,494 Explore Cost 727

2018 2018 WEB H HITS

Website Utilization

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Root Canal, 77 Wisdom teeth removal, 63 Braces - Adult, 49

Deep Cleaning, 78 Implant, 84

Tooth Removal, 59 Bridge, 27 Dentures, 29 Checkup - Child, 12 Gum Surgery, 26

Filling, 100 Crown, 97

Checkup - Adult, 71 Braces - Adolescent, 43

2 0 18 C O ST ES T IMATOR

 24.8% of active enrollees have an online account  2.8% increase from 2017 in online accounts  4% increase in member log-ins  15.2% increase in cost estimator tool

Thank you for being a valued customer and partner!

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