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Delta Dental outlines Smile Way wellness benefit and flags dental underuse among members
Summary
Delta Dental told the HSS board that its Smile Way wellness benefit is rolling out and that an unexpectedly large share of members had not received basic cleanings (about 36.5% of active members); the vendor proposed targeted outreach, web enhancements and a cost-estimator tool to boost utilization.
Sharon Stanek Lowe of Delta Dental presented an overview of dentist credentialing, network access and the Smile Way wellness benefit to the San Francisco Health Service System Board.
Delta described credentialing processes (NCQA-aligned checks, malpractice and DEA verification) and said access to PPO and Premier dentists is high within the HSS geography. The Smile Way wellness benefit (effective Jan. 1, 2019) offers additional preventive dental services to members with selected chronic conditions (diabetes, heart disease, HIV/AIDS, rheumatoid arthritis and stroke) at no charge to participants.
Stanek Lowe also reviewed the new cost-estimator tool that integrates member deductible and annual maximum status to estimate out-of-pocket costs for common procedures. Delta reported utilization statistics through September: 36.5% of active members had not had a cleaning this year, 42% had at least one cleaning, and 2.4% exceeded the annual maximum. Delta proposed email campaigns, website placement of flyers and retiree outreach to increase enrollment in Smile Way and preventive utilization.
Board members asked about why so many members had not obtained at least one cleaning; Delta said it is launching focused campaigns and recommended member outreach and focus groups to identify barriers.
