With Delta Dental collaboration, Tufts Health Plan drills down on care quality improvement efforts

Amid the ever-present pressure to reduce costs and improve outcomes, health insurers have increasingly found that the best way to achieve these goals is to collaborate with other organizations.

For many insurers, the obvious choice has been to partner with providers. Tufts Health Plan is no exception, but it has also taken it one step further—by teaming up with a dental plan.

In March, the nonprofit insurer announced a collaboration with Delta Dental of Massachusetts, which has three primary components: Data sharing, targeted member engagement and provider collaboration. Through the partnership, employers will also have access to a reduced premium when they bundle the medical benefits from Tufts Health Plan and dental coverage from Delta Dental of Massachusetts.

The partnership builds off a pilot program that targeted individuals with chronic conditions who carried policies from both companies. It also follows a similar partnership established last fall in New Hampshire between Tufts Health Freedom Plan and New England Delta Dental.

Michele Wolfsberg

The reason for health insurers and dental plans to join forces is simple, according to Michele Wolfsberg, R.N., Tufts Health Plans’ senior manager of clinical strategy and commercial products. Dental health plays a major role in overall health, she told FierceHealthcare, so “it does make sense to take care of the whole person.”

Dentistry and diabetes

More specifically, there are numerous ways that dentistry and general medicine intersect, according to Claire Levesque, M.D., Tufts’ chief medical official of commercial products.

“One of the things we’ve learned from colleagues is diabetes is very intertwined with dental care,” she said, noting that having periodontal disease, especially, makes it more difficult for diabetics to control their blood sugar.

Thus, she said, “we’re looking at different ways we can be innovative around this.”

For example, Delta Dental is exploring the possibility of testing patients’ hemoglobin A1c right in the dentist’s office. And since Tufts already issues wallet cards reminding diabetic members to get regular medical care, those cards will now include reminders to visit the dentist regularly, Levesque said.

Tufts is also contacting employer groups that it works with to seek permission to comb through data and identify employees with diabetes, then send them communications reminding them to get regular dental care, she added.

The bigger picture

The Delta Dental partnership is also influencing the outreach efforts that nurse care managers conduct among patients with chronic conditions, Wolfsberg said.

“One of the things we did when we started [working] with Delta Dental is talk about key questions nurse care managers should be asking,” she said. As a result of those discussions, Tufts embedded dental health-related questions into the questionnaires that help care managers learn more about patients.

Claire Levesque

In addition to being critical for patients with diabetes and other chronic conditions, adequate dental care is important for pregnant women, as it reduces the risk of giving birth prematurely, Levesque noted. Plus, among older patients, having strong teeth is also vital to ensure proper nutrition.

Tufts has also learned from Delta Dental that many dentists want 11- and 12-year-olds to get an HPV vaccine so they don’t later have to treat them for oral cancer, as the two are linked, according to Levesque. Therefore, the insurer has considered lobbying state legislators to approve dentists to give the vaccine, she said, pointing out that many middle-school-aged children see their dentist more often than their primary care physician because that’s the time they typically have braces.

“We can certainly advocate for that and try to move that forward,” Levesque said.

What’s next

As for other future plans for the partnership, Levesque said Tufts is also looking at gaps in care—specifically in terms of how it can target messages to someone who is only going to dentist once a year when they should be going more often, for instance.

However, “that’s a little longer range because it takes some more sophistication in the data,” she noted.

Moving forward, the most important piece of any partnership—like that between Tufts and Delta Dental—is to improve the quality of care, Levesque emphasized.

“We do think there’s going to be reductions in healthcare costs, but those are going to take a while,” she said.

For example, if a diabetic gets his or her blood sugar under control, a health insurer won’t see returns from that for roughly two years. But Tufts is willing to wait for the financial piece given the other benefits of collaborating.

“As a company, Tufts Health Plan is very committed to this,” Levesque said. “We think this is the right thing to do.”