UnitedHealthcare ' \ i al~/ ~ - . ~ -: An Innovative DHMO - - PDF document

SLIDE 1

Broward County Governme~t

DHMO Dental Finalist Presentation

ApriI 24th , 2019

FLORIDA

Sara Davis Laurie Mandell

Introductions Manager OCSM & FAM

VP, Account Management

United Healthcare

Joe Vidal Jim Moore

attendees:

Senior Account Executive Strategic Account Executive

• Local Leadership
• Proven Account Management Team
• Local Decisions
• Proven Implementation Capabilities

Consistently recognized as a leader in the health industry.

THE CNIC 50

Since 2012, UnitedHealth

Grou p ranked as one of the 50 mos t community- min ded companies in the nation by The Civic 50, a Points of Lig ht initiative.

2018 2018

NATIONAL BUSINESS GROUP ON HEALTH

In 2018, received a

platinum award for "Best Employers for

Healthy Lifestyles."

FORTUNE MAGAZINE

Pan of the Dow Jones Sustainability World In d ex.

2018 2018

FORTUNE 500 UST

2019

In 2018, UnitedHealth G roup ranked No . 5.

OOVVJONES

In 201 9, UnitedHealth

Group r a nked No. 1

in its secto r for

innovation.

2019

VICTORY MEDIA

Named a 2019 Military Frie ndly Employer.

F ORTUN E MAGAZINE

In 201 9, UnitedHealth G roup Named Wor ld's

Most Admired Compa ny in t he Insu rance and Managed Care sector.

2019

The power of partnership is built on working together toward the same goal.

Our values:

Honor comm itments. Walk in the shoes Build trust Invent the future. Demonstrate Never compromise

• f people we seNe

through learn from the excellence in ethics. a nd those with collaboration. past. everything we do. w hom we work.

~

UnitedHealthcare'

SLIDE 2

An Innovative DHMO

Unique delivery model. Comprehensive benefits..

• Fee­for­service model I

no capitation.

• No dentist assignments,

no provider office rosters to verify eligibility.

• Members can switch offices

at any time with no wait -

• pen access to care.
• No closed offices.
• No waiting periods.
• No maximums.

A network free of the typical

pain points

associated with traditional benefit carriers.

• Savings on implants with specific fee, abutments, prosthesis

removal and crowns.

• 490 procedures covered at a copayment level.
• Prenatal benefits.
• Oral cancer screening.
• Cosmetic benefits at specific copayments I discounts.
• Pediatric dentistry up to age 16.
• Discount on procedures not listed on the Schedule of

Benefits.

• Allows for a better view into use of preventive care services.

You can say

Open access:

goodbye

freedom

to frustrating to satisfied

to choose hello

rosters, and employees

anyone in our network.

by providing access to quality, affordable care.

Capitation hast potential to More than 50% of capitation

­tonger average

increase a patient' s heatth risk plan participants reported appointment delays were

1

because there are incent1ves

to

dissatisfaction with the p lans related to acceptance of reduce services and capitat ion models

2 3

In centives t9 defer

care

1 Americ an Dental A oso c 1

ation He alth Policy p ubhc.:itlon. 2.Departrnont of H ealth Services G tudy 3lJnlver•rty of Qihfornin D eportment

• f Medlc1

study

Value-Added Benefits

Enhanced prenatal benefits

Oral cancer screenings

Benefitsduring pregnancyand three months follow ing

Covered oral

cancer screenings each year using the

delivery are not applied to frequency limits or the annual maximu

m . new est technologies for earlydetection.

D id you

know?...

D id

you know?

...

G

um disease mayincrease therisksof pre·term birth and 101·1birth

Mou th lesions

a re not a

lwa

ys e

asily s

ee n

during a

routine

• vieight. 1

exam.

Gum inflammation can potent

i al~/

play arole in the development of

And an estimated 1in 92 adults w

ill be diagnosed with oral

pre­eclampsia

.2

cancer in

their lifetim

e.3

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SLIDE 3

­­­­­

____

500

Provider Network

Net

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The Mouth­Body Connection

The Lungs: gum disease may increase the

E The Brain: oral bacteria has been identified

f"_~Tj

as a possible contributor to Alzheimer's risk of chronic obstructive pulmonary disease

• disease. 1

(COPD).3

/'!'!'\.

~

The Heart: Gum disease may increase your

....

~

. The Panc reas: The pancreas produces

insulin, the hormone responsible for controlling blood sugar. Treating gum disease can improve your ability to manage your

.l,(T'"e' car ~:~1

er-• , :t P~

;o:•"''.J'?.J'I 2C •

5

risk of heart disease and stroke.2 The Kidneys: Poor oral care makes infections progress faster, which means more work for your kidneys.2

3

.0."""2'"Car' . ~

i;3j9-•; :~

P­;:r,cr.cr!:IC:J'I 2C" •. Brfdge2Health (updated)

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15.0% of adult members, driving 60.4% of the medical spend

Bridge2Health Delivers:

• Specific reporting showing aggregated data for Broward County members
• Increased engagement from members in the "at risk" category
• Increased compliance with dental care
• Decreased medical claim costs for these engaged members = less member out of

pocket costs

Brldge2Health Re•ul~

II

lntegrJte d Fln~ncl:ds

CMoetu and HurtlunlJ

I l n•·i!l._,.tf, _

.,,. ·

57% 32% 27%

­­­­­­­­-

Net Paid PMPM for Dental Compliant= $741 vs. Non­Compliant= $1,134 Statewide

, Jc9 , 300 1000

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.: G-~a

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DHMO access:

94010

• f all eligible employees

& retirees have access

to at least two DHMO general dentists within five miles of their home.

Unique Offices

800 600

J O O

200

South Florida

SLIDE 4

UnitedHealthcare's Value Proposition:

v' Local Presence

• Large UHG/UHC employee population based in Broward
• Senior Leadership to support the Account Management Team
• Account Management Team (AMT) including a Strategic Account Manager, Field Account

Manager and a dedicated nurse, nutritionist, and two on­site representatives working with Broward County members daily.

v' Company Profile

• #1 Nationally ranked provider of benefits with regards to premium, employees, providers and

membership

• Ranked #5 on the Fortune 500 list
• Largest DHMO Network in South Florida with a GEO access over 99% for the tri­county area

v' Quality of Service & Customer Service

• Advocate4Me service team available to help members with their medical, vision and dental

questions at one phone number with one ID number

• Open access DHMO plan network which removes the barriers for members to see a provider
• Provider Relations Team dedicated to credentialing and re­credentialing our providers, verifying

their continuation of their license with the State and providing this information for members to access

v' Enrollment & Implementation

• Proven Implementation Team able to enroll Broward County's medical coverage in under 30

days

• AMT familiar with the Broward County employees and the Open Enrollment processes
• Medical, dental and vision in one booklet, available in various languages if needed

v' Project Specific Questionnaire & Performance Guarantees

• Experienced with large Public Sector groups in South Florida and skilled at best practices for

higher member engagement

• Understand the culture within Broward County and can help guide members through all of their

benefits via web based tools, apps, telephonic member support and coaching along with on­site team members

• Agreed to all Performance Guarantees without exception

v' Plan Benefits

• Open access network removing barriers for many members to see a dentist
• 490 dental procedures covered at copay level
• Prenatal care and oral cancer screening benefits

v' Network/Provider Disruption

• 95% of current top providers in the DHMO network, with the balance being worked on by

Provider Relations for recruitment

• Increased DHMO provider network allowing more members who may be on the PPO plan or not

covered to now come on the DHMO since their dentist now may be participating

• Pediatric dentists covered up to age 16, allowing more children to stay/see a dentist who they

feel comfortable with and enjoy going to

v' Price

• Proposed premiums to match current premiums that members are paying for ease of

administration, implementation and open enrollment

• Bridge2Health program to help members to be healthier through having proper dental care and

helping them to avoid hundreds to thousands of dollars in medical costs

• UnitedHealthcare is willing to have further negotiations with Broward County regarding the fees

and premiums for medical, dental and vision plans