Latest / Becker’s Payer Issues Podcast / Expanding Access to Affordable Dental Care with Cigna Healthcare and Paytient

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Expanding Access to Affordable Dental Care with Cigna Healthcare and Paytient · Becker’s Payer Issues Podcast

• 0:00
  Hello, everyone. This is Jacob Emerson with the
• 0:02
  Becker's Pay Your Issues podcast.
• 0:04
  Thrilled today to be joined by Dave Verkani,
• 0:06
  who is the vice president of innovation, market
• 0:08
  insights, and communications
• 0:10
  within Cigna Healthcare's dental and vision business. Dave,
• 0:13
  thanks so much for taking the time to
• 0:15
  be with me on the podcast today.
• 0:17
  Great. Thanks, Jacob. Appreciate the the time and
• 0:20
  opportunity to be here. Absolutely. And, Dave, before
• 0:22
  we dive into everything we wanna talk with
• 0:24
  you about, can you first tell us a
• 0:25
  little bit more about yourself, your background in
• 0:27
  health care, and what it is that you
• 0:29
  do today at Cigna?
• 0:31
  Sure. So I've been with Cigna for twenty
• 0:34
  three years, hard to believe. Came from the
• 0:36
  financial services industry before moving to health care.
• 0:39
  And, part of my current role, which as
• 0:41
  you mentioned, is leading innovation and market insights
• 0:44
  for our dental and vision business,
• 0:47
  I held roles different leadership roles in marketing,
• 0:50
  in business development,
• 0:52
  market research, provider,
• 0:54
  strategy,
• 0:56
  and affordability
• 0:57
  strategy in lots of different businesses across the
• 0:59
  Cigna portfolio. So, fairly broad health care background.
• 1:03
  Fantastic. Well, Dave, like I said, we appreciate
• 1:05
  you taking the time to sit down with
• 1:07
  us. And I I wanna dive right in
• 1:09
  by talking about,
• 1:11
  an initiative that Cigna just announced,
• 1:14
  recently,
• 1:15
  expanding access to flexible dental payments to 2,800,000
• 1:19
  more of your members.
• 1:21
  So for our listeners who might not be
• 1:23
  familiar with what exactly is happening here, can
• 1:26
  you give us a breakdown of of how
• 1:27
  you're achieving this, what you're hoping to to
• 1:30
  achieve, and what your timeline has been here?
• 1:32
  Yeah. Happy to.
• 1:35
  The goal behind the program that that we're
• 1:38
  talking about
• 1:39
  today is Cigna really was looking to figure
• 1:42
  out ways we could improve people's health by
• 1:44
  removing cost as a barrier to getting needed
• 1:46
  care. So even though somebody might have coverage,
• 1:48
  they might have insurance, it doesn't mean that
• 1:50
  they can necessarily afford to use their benefits
• 1:53
  all the time.
• 1:54
  And we wanted to make sure we could
• 1:55
  find ways to help people remove that barrier
• 1:57
  and get the most out of their benefits.
• 1:59
  So this initiative is a partnership with
• 2:03
  a company called Patient.
• 2:05
  And as part of our market launch,
• 2:08
  we've launched patients employer sponsored benefit. And the
• 2:11
  the basic way it works is it it
• 2:12
  provides employees
• 2:14
  with an on demand credit line that they
• 2:16
  can use to pay for out of pocket
• 2:18
  health care costs.
• 2:19
  And it's got really flexible
• 2:21
  repayment terms with, this is was really important
• 2:24
  to us. No interest or fees to the
• 2:26
  the consumer or customer or or member,
• 2:29
  whichever term you wanna use. We wanted to
• 2:31
  make sure this wasn't putting potentially some additional
• 2:33
  burden
• 2:34
  on them by requiring them to actually pay
• 2:36
  credit card fees. And, as is mentioned, it's
• 2:39
  an employer sponsored benefit, so employers are choosing
• 2:42
  to offer this
• 2:43
  to their employees
• 2:45
  and decide which health care cost,
• 2:47
  categories are covered and can also determine things
• 2:49
  like the credit line that they're offering, and
• 2:51
  repayment terms. And I think we also importantly
• 2:54
  before we talk about kind of the expansion
• 2:56
  here
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  is,
• 2:58
  from the employer perspective,
• 3:00
  they don't take on any credit risk.
• 3:02
  Patient actually takes on the full financial liability
• 3:05
  on collected payments. So there's some protection for
• 3:07
  both the employer
• 3:09
  and the employee. And the last kind of
• 3:11
  benefit I mentioned in terms of things we
• 3:12
  were looking to get out of this kind
• 3:13
  of program,
• 3:15
  we're very focused on the health care providers,
• 3:17
  the dental providers in our network, and our
• 3:19
  relationships with them. They're the ones who actually
• 3:21
  deliver care to our customers,
• 3:22
  and and this also benefits the providers in
• 3:24
  the sense that it helps
• 3:26
  reduce bad debt or challenges in collecting patient,
• 3:29
  payment responsibility.
• 3:32
  I appreciate you taking us through that, Dave.
• 3:33
  And so this is an existing partnership. You've
• 3:36
  you're now expanding it.
• 3:38
  Let's get to the core of what I
• 3:40
  think a lot of our listeners will be
• 3:41
  curious about, and it really is how is
• 3:43
  this improving access to preventive care, to critical
• 3:47
  dental procedures for your members,
• 3:49
  and what are some of the impacts you've
• 3:51
  seen already, you expect to see, in terms
• 3:53
  of member satisfaction and, of course, health outcomes?
• 3:57
  Sure. And maybe, Jacob, before I jump into
• 3:59
  that, I should probably mention something that is
• 4:00
  relevant to, I think, you know, some of
• 4:02
  the press releases and things that led to
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  this, you know, podcast in the first place.
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  So
• 4:06
  we launched this initially as part of a
• 4:08
  pilot in 2024
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  to our national accounts business segment, which is
• 4:13
  very large employers with more than 3,000 employees.
• 4:16
  And and the more recent news is that
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  we've made it available to our middle market
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  segment, think mid sized employers
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  with between 503,000
• 4:24
  employees. So now with that expansion,
• 4:27
  we've actually now got across our book of
• 4:30
  business,
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  13,000,000
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  of our covered individuals, our customers
• 4:34
  nationwide who are actually eligible for this this
• 4:36
  program. So,
• 4:37
  I could talk a little bit about the
• 4:39
  the impacts. We wanted to make sure, you
• 4:40
  know, the the potential scope of where this
• 4:42
  is available was was, was clear as well.
• 4:45
  Absolutely. No. I appreciate you clarifying that. So
• 4:47
  13,000,000 members now eligible,
• 4:49
  for this program. But, Dave, I'll let you
• 4:52
  continue in terms of, what what it's achieved
• 4:54
  so far in terms of metrics.
• 4:56
  Sure.
• 4:57
  You know, when you look at again, our
• 4:59
  goals were behind this program.
• 5:01
  If you look at, the opportunity to prevent
• 5:04
  oral health issues because this as I mentioned,
• 5:06
  this started with our dental, you know, product.
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  We've kind of expanded it beyond that. But,
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  by preventing oral health issues
• 5:13
  that people might have,
• 5:14
  those can really lead to much broader systemic
• 5:17
  problems.
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  For example, gum disease has been linked to
• 5:21
  lots of other serious health issues like heart
• 5:23
  disease and diabetes,
• 5:25
  or people showing up in the emergency department
• 5:28
  to treat, dental pain and infection. That's a
• 5:30
  really inefficient and very expensive way to to
• 5:33
  address dental pain.
• 5:35
  And those are some of the reasons, you
• 5:37
  know, why we were motivated to do to
• 5:39
  do this, as well as just helping people
• 5:41
  use their benefits more effectively.
• 5:43
  And,
• 5:44
  when you look at our own
• 5:47
  launch here,
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  we basically have had some pretty,
• 5:51
  encouraging results. So
• 5:54
  when you think about
• 5:55
  out of pocket costs for essential dental services,
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  things like, you know, a crown or a
• 6:00
  root canal can exceed the typical
• 6:03
  1,500
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  to $2,000
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  annual dental benefit cap that is is very
• 6:08
  common in dental insurance.
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  And that can lead people to delay or
• 6:13
  or even forego care altogether, which we're absolutely
• 6:15
  trying to avoid. And cost is the number
• 6:18
  one reason
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  that people actually avoid dental visits.
• 6:22
  In fact, forty percent of adults
• 6:24
  in survey, I think, was from last year,
• 6:27
  identified that they had skipped dental care or
• 6:29
  routine checkups in the past year because they
• 6:31
  actually had financial concerns. So when we look
• 6:34
  at our results
• 6:36
  from our launch so far, we've seen a
• 6:38
  measurable increase in both preventive care usage and
• 6:42
  critical dental procedures as well.
• 6:45
  And also seeing really just, I think, good
• 6:47
  levels of engagement in the patient program
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  overall,
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  across
• 6:52
  the clients that we have on the program
• 6:54
  currently.
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  We've got a sign up rate of
• 6:57
  nearly 20 on average, so about 20% are
• 7:00
  actually signing up for the patient benefit.
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  About 11%
• 7:04
  of the eligible employees are actually activating,
• 7:08
  the patient,
• 7:09
  Visa card.
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  And nearly 70% of the people who activate
• 7:14
  the card are actually making transactions on the
• 7:16
  card. So we're we're seeing, first of all,
• 7:18
  people engaging with this with the with the
• 7:20
  solution and using it the way we we
• 7:23
  want them them to. And, actually,
• 7:25
  other data point that I think is actually
• 7:27
  really important is of the people that that
• 7:28
  had a transaction on the card, it wasn't
• 7:30
  a one and done
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  thing. Ninety percent, of those people actually had
• 7:35
  a repeat transaction, so they were continuing to
• 7:37
  use it for ongoing care, which is really
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  important.
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  And
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  from a from a just a care improvement
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  perspective,
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  among the users of the the patient,
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  card,
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  our data analysis that we did in conjunction
• 7:51
  with patient shows a measurable increase in both
• 7:54
  preventive care,
• 7:56
  as I mentioned, I think, and also critical
• 7:57
  dental procedures.
• 7:59
  And most frequently, that's things like fillings, crowns,
• 8:02
  and oral surgery, so the more expensive,
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  procedures, which is what we were looking for.
• 8:08
  And this might be, kind of one of
• 8:09
  the the the stats that I was most
• 8:11
  encouraged by. We did a survey
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  of SEGI customers who are using patient, and
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  ninety three percent of them
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  actually said they would have skipped care
• 8:21
  if they didn't have access to the patient
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  card, which is, you know, exactly the type
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  of behavior we were hoping to to to
• 8:27
  influence.
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  So, you know, really encouraging, I think, in
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  terms of early results.
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  We're also seeing really high satisfaction with with
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  the patient program.
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  We've got a net promoter score of 83,
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  which in, you know, the health care industry
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  is extra extremely high and, 4.9
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  out of five
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  rating on Trustpilot from all the reviews that
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  people actually posted online. So, you you know,
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  across the board, actually quite encouraged by, by
• 8:53
  the results so far.
• 8:55
  Absolutely. So based off everything you just said,
• 8:57
  some of those numbers you cited there, Dave,
• 8:59
  this model is clearly demonstrating measurable increases in
• 9:02
  preventive and critical care utilization.
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  So then I wonder, you know, how how
• 9:06
  do you see this driving long term cost
• 9:08
  savings for for both employers,
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  but also the health plan itself, especially,
• 9:13
  when considering the potential for earlier interventions and
• 9:16
  the scalability of this model for for smaller
• 9:19
  employers perhaps?
• 9:20
  Yeah. That's a great question. And that is
• 9:22
  really, you know,
• 9:23
  the heart of this because,
• 9:25
  you know, generally, the dollar saved now is
• 9:27
  is in prevent a dollar spent, I should
• 9:29
  say, in prevention now really does pay off.
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  We looked at a lot of data points
• 9:34
  as we're launching this program to to exactly
• 9:36
  the point, Jacob, that you made.
• 9:38
  So preventive oral care really does play a
• 9:40
  crucial role in lowering health care costs over
• 9:42
  a person's lifetime.
• 9:44
  Studies show that for each dollar that people
• 9:46
  actually invest in
• 9:48
  oral care prevention can save somewhere between $8
• 9:51
  and $50
• 9:52
  in later restorative and emergency treatments.
• 9:55
  And,
• 9:57
  even more importantly, because the real dollars, let's
• 10:00
  be honest, are less so in the dental
• 10:02
  space versus the broader medical, you know, world
• 10:04
  where things like, your hospital stays, inpatient costs,
• 10:07
  specialist costs,
• 10:09
  are significantly more expensive.
• 10:12
  There's a real cost savings opportunity there too
• 10:14
  and health improvement opportunity.
• 10:17
  If you look at the average medical cost
• 10:19
  savings for people
• 10:20
  who are consistently getting preventive dental maintenance,
• 10:24
  the the average cost savings there over time
• 10:27
  is actually just over 6%, which may sound
• 10:30
  like a fairly modest number. When you look
• 10:32
  at the dollars involved,
• 10:34
  on medical care, you're talking about, you know,
• 10:37
  huge dollars very, very, very quickly.
• 10:40
  Yeah. No. That makes a lot of sense.
• 10:42
  That it's the savings isn't necessarily coming from
• 10:44
  the dental space. So I think the the
• 10:47
  natural question there, Dave, is what is the
• 10:49
  potential for scaling this type of flexible payment
• 10:52
  model into other areas of health care, vision,
• 10:55
  behavioral health services?
• 10:57
  Ultimately, where do you kinda see the future
• 10:59
  of this going?
• 11:00
  Yeah. We we actually, that's the thing we
• 11:02
  spent a lot of time about talking with
• 11:03
  with patient, and some of our of our
• 11:05
  large employer clients. And we we initially focused
• 11:08
  on offering
• 11:09
  the patient solution to our Cigna Dental employer
• 11:12
  clients,
• 11:13
  and we kind of piloted it within with
• 11:15
  my within my team and our Cigna Dental
• 11:17
  business. But we quickly recognized that employers who
• 11:20
  were interested in this kind of program and
• 11:22
  would buy into,
• 11:23
  something like this would actually wanna offer this
• 11:26
  across their health care benefits, not just for
• 11:28
  dental. So across medical,
• 11:30
  pharmacy, behavioral health, vision, etcetera.
• 11:33
  While we started with Cigna dental clients in
• 11:36
  a dental only option,
• 11:38
  we've actually expanded this, and it's currently available,
• 11:42
  to employer clients either for a dental only
• 11:45
  option or
• 11:46
  across all their benefits. And not only that,
• 11:49
  but whether or not those other benefits, medical,
• 11:51
  pharmacy, etcetera, are with Cigna
• 11:54
  or not. And and I think the the
• 11:56
  reason for that is exactly what you just
• 11:58
  touched on, which is
• 12:00
  while there are absolutely cost saving opportunities just
• 12:03
  specifically within the dental care space,
• 12:06
  the real health improvement opportunities
• 12:08
  and cost savings actually accrue more to the
• 12:11
  medical side if you could start with oral
• 12:13
  health care. So, yeah, we're excited about broadening
• 12:15
  this to more of our clients, including those
• 12:17
  that don't even have, you know, Cigna Medical
• 12:18
  or behavioral.
• 12:20
  And we are looking at, the potential to
• 12:22
  broaden this to even more of our clients,
• 12:25
  specifically including those that are not currently Cigna
• 12:28
  Dental clients. So I think there's a lot
• 12:30
  of upside here. And and and to your
• 12:31
  point, we we've already,
• 12:33
  kind of taken that first step to expand
• 12:36
  and scale this, beyond beyond dental.
• 12:40
  Absolutely. So it sounds like big things to
• 12:42
  come here.
• 12:43
  Dave, before we go, what else are we
• 12:46
  missing? You've got the attention of a lot
• 12:48
  of other health plan leaders from all over
• 12:50
  the country right now. What else do you
• 12:51
  wanna share with them on this topic, or
• 12:53
  is there any other final bits of advice
• 12:55
  that you would wanna
• 12:56
  share, while while we're on the call today?
• 12:59
  I think one thing I would highlight is
• 13:01
  that,
• 13:02
  which we didn't really talk about is while
• 13:04
  this has broad, potential, I think, the the
• 13:07
  approach of helping people
• 13:10
  use their benefits effectively and actually get the
• 13:13
  care they need,
• 13:14
  even if they have coverage, we should not
• 13:15
  assume that they can afford to use it.
• 13:17
  And the program like this does allow them
• 13:19
  to actually afford to use the benefits that
• 13:21
  they're paying for.
• 13:23
  And and in particular,
• 13:24
  you know, we've tried to figure out if
• 13:26
  there are employer clients we had that had
• 13:28
  employee demographics
• 13:30
  who could particularly benefit from something like patient.
• 13:33
  So for example, lower wage or hourly workers
• 13:36
  who might struggle to pay these kinds for
• 13:38
  these kinds of costs, employer clients who have
• 13:40
  high concentrations,
• 13:43
  of employees with social determinants of health challenges,
• 13:45
  that type of thing. And
• 13:47
  I should have actually mentioned this in terms
• 13:49
  of some of the results of the program,
• 13:50
  but we we were really, you know, hoping
• 13:53
  that we were going to see more people
• 13:55
  in communities that are facing even greater financial
• 13:58
  barriers take advantage of the program, but we
• 13:59
  weren't sure until we started this. Luckily, we
• 14:02
  did actually see exactly that.
• 14:05
  We're actually seeing,
• 14:06
  higher utilization
• 14:08
  amongst,
• 14:09
  individuals who have, you know, higher SDOH
• 14:12
  or SDI challenges than the general population. So
• 14:15
  I think in addition to everything we talked
• 14:17
  about, there's also a real opportunity to support
• 14:20
  diverse
• 14:21
  populations and kind of disproportionately
• 14:23
  provide assistance to people who struggle even more
• 14:25
  with with the cost of care.
• 14:28
  Yeah. No. That's a great last call out
• 14:29
  there, Dave, that so far this model is
• 14:31
  really,
• 14:32
  helping a lot more people who are living
• 14:35
  in underserved communities. So I really appreciate you
• 14:38
  you hooking that on there.
• 14:39
  And and overall, thank wanna thank you for
• 14:42
  taking the time to chat with us on
• 14:44
  the podcast. We we really appreciate it. My
• 14:46
  pleasure. Great to talk to you, Jacob. Thank
• 14:47
  you. You as well. And to our listeners,
• 14:50
  if you'd like to listen to more podcasts
• 14:52
  from Becker's Healthcare, you can visit beckershospitalreview.com.