City of Los Angeles 2018 Annual Dental Review September 5, 2019
2018 Summary of Activities Healthy Teeth, Healthy Body Webinar Preventive Care Seminars Key ey A Activi vities es 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 Dental l Utiliz izatio ion Decrease in cleaning utilization for employees & members Increased website utilization Exploring digital promotional campaigns Future A Fut Activ ivities Enhancing benefits to include coverage for posterior composite fillings Continued support of City’s wellness initiatives 2
Enrollment Snapshot Primary Enrollees Enrollment Change 20,000 17,057 16,787 PPO: +1.6% 15,000 8,513 8,209 10,000 Preventive: + 2.0% 5,000 DCUSA: + 3.7% 556 545 0 PPO Plan Preventive Plan DHMO Plan 2017 2018 2017 2018 Average Contract Size* % Change Average Average PPO: -1.7% Plan EE Members Contract EE Members Contract Size* Size* Preventive: -1.3% PPO 16,787 37,891 2.257 17,057 37,830 2.218 DCUSA: - 2.3% Preventive 545 749 1.374 556 754 1.356 DHMO 8,209 17,008 2.072 8,513 17,239 2.025 2018 Average Member Age 60.0 50.0 48.8 49.2 47.2 47.0 46.6 46.0 43.5 50.0 40.0 30.0 15.0 13.6 14.0 12.5 20.0 10.0 0.0 PPO Preventive DHMO Benchmark Primary EE Spouse/DP Child *Average Contract Size – Ratio of total covered Members divided total covered Employees 3 ** Benchmark data throughout this presentation is Delta Dental’s overall Book of Business, except where otherwise noted.
PPO Financials & Savings $80.37 $79.64 $85.00 $77.53 $75.77 2.0% decrease in total claim costs, 3.5% $75.00 decrease on a PEPM basis $65.00 $55.00 Decrease in contract size $45.00 Steady growth in PPO Utilization $35.00 Increase in network savings $25.00 2015 2016 2017 2018 PEPM Claims 100.0% 40.0% 36.1% 35.3% 34.2% 80.0% 35.0% 28.8% 29.6% 30.0% 64.4% 65.2% 65.9% 27.5% 60.0% 25.0% 20.0% 16.7% 16.3% 40.0% 14.7% 15.0% 10.0% 20.0% 30.2% 29.6% 28.6% 5.0% 5.4% 5.2% 5.5% 0.0% 0.0% 2016 2017 2018 2016 2017 2018 Network Network PPO Premier Net effective discount Savings Utilization Non-contracted Premier PPO 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 4 Non-contracted Dentist: Out-of-network provider that has not agreed to discount fees
PPO Risk Trends: Year Over Year 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. 5
Wellness Objectives PPO and Preventive Plans EMPLOYEES Avg. Period No Visits Exams Cleaning # EE’s 2017 17,332 5,989 34.6% 11,253 64.9% 10,641 61.4% 2018 35.0% 64.7% 60.4% 17,613 6,172 11,397 10,637 RESULTS: GOALS: Minimal changes in employee utilization Increase # of employees receiving preventive care 0.2% decrease in # of exams Increase the # of employees visiting 1.0% decrease in # of cleaning dentists 0.4% increase in # of employees not visiting a dentist 6
Wellness Objectives PPO and Preventive Plans 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% DELTA DENTAL BENCHMARK* • No Visits – 21.4% • Exams – 62.4% • Cleaning – 64.5% OPPORTUNITIES TO IMPROVE UTILIZATION: OBSERVATIONS: Target new hires and non-users Continued promotion of the City’s wellness objectives should contribute to Digital campaigns closing utilization gaps between the City Explore partnering opportunities with and Delta Dental’s benchmarks Limeade Continued participation in City’s wellness program 7 *Delta Dental’s benchmark data is based on member’s who have been eligible for at least 12 months
Utilization by Category 2018 Distribution by # of Procedures PPO Pl PPO Plan n (exclud ludes P Preventive Pl Plan) n) 60.0% 46.5% Diagnostic & 48.3% 48. Basic Major 50.0% Preventive Services Services 40.0% 27.3% 30.0% 22.2% 22. 9.3% 20.0% 5.7% 10. 10.2% 2.7% 3.7% 7.3% 3% 2.5% 0.3% 0.6% 10.0% 0.9% 3.9% 9% 2.7% 7% 2.5% 5% 1.1% 1% 0.8% 8% 0.4% 4% 0.0% 2018 Benchmark 2017 2018 Benchmark +/- Classification Closing care gaps (i.e., increased Diagnostic & Preventive 70.4% 70.5% 73.8% utilization of preventive services) Basic 23.8% 23.8% 21.1% could mitigate the financial impact associated with major Major 5.7% 5.8% 5.1% services 8
Utilization by Category 2018 Distribution by # of Procedures DHMO 57.3% 60.0% 52.3% Diagnostic & Basic Major Preventive Services Services 50.0% 40.0% 30.0% 17.9% 20.0% 14.1% 8.4% 6.2% 3.9% 4.0% 9.7 .7% 0.5% 5.4 .4% 0.4% 10.0% 1.7% 3.2 .2% 2.7 .7% 1.9 .9% 0.2 .2% 0.4 .4% 0.0% 2018 Benchmark 2017 2018 Benchmark +/- Classification Member utilization trends Diagnostic & Preventive 69.2% 71.4% 70.2% compare favorably with Delta Basic 26.9% 24.8% 24.9% Dental’s DCUSA Book of Business Major 3.9% 3.8% 5.0% benchmarks 9
Website Utilization Explore Cost 727 24.8% of active enrollees have an online account 2.8% increase from 2017 in online accounts 4% increase in member log-ins ID Card Documents 3,468 3,494 15.2% increase in cost estimator tool 2 0 18 Claims C O ST ES T IMATOR Benefits 4,401 Braces - 6,956 Adolescent, 43 Checkup - Root Canal, 77 Adult, 71 Wisdom teeth removal, 63 Braces - Adult, 2018 2018 49 Crown, 97 WEB H HITS Deep Cleaning, 78 Filling, 100 Implant, 84 Gum Surgery, 26 Tooth Removal, Bridge, 27 59 Dentures, 29 Checkup - 11 11 Child, 12
Thank you for being a valued customer and partner! 12
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