Latest / Becker’s Payer Issues Podcast / Dr. Richard Celko, Chief Dental Officer at UPMC Health Plan

Transcript

Dr. Richard Celko, Chief Dental Officer at UPMC Health Plan · Becker’s Payer Issues Podcast

0:00
Hello, everyone. This is Jacob Emerson with the
0:03
Becker's Panger Issues podcast.
0:05
We're going to be joined by doctor Richard
0:07
Selco, who's the chief dental officer at UPMC
0:10
Health Plan. Doctor Selco, thank you so much
0:12
for taking the time to be with me
0:13
on the podcast today.
0:15
Jacob, thank you for the opportunity to discuss,
0:18
some things relevant to oral health. Yeah. Absolutely.
0:21
And before we dive into everything we wanna
0:23
talk with you about, Richard, can you tell
0:24
us a little bit more about yourself, your
0:26
background in health care, and what it is
0:28
that you do today at UPMC?
0:31
Sure. My background in, in dentistry or health
0:35
care started back
0:37
in '19,
0:38
'85 when I graduated from Saint Vincent College,
0:42
in Latrobe.
0:43
I went to, I was luckily and fortunate
0:46
enough to be accepted at
0:47
the University of Pittsburgh School of Dental Medicine,
0:50
and I did my four years of training
0:52
at,
0:53
at University of Pittsburgh,
0:55
dental school and followed that up with one
0:57
year of a hospital based residency at Montefiore
1:00
Hospital here in Pittsburgh as well.
1:03
I spent nearly ten years in private practice
1:06
with my,
1:07
I I took over my father's practice after
1:10
he retired
1:11
in 1990
1:12
and
1:14
practiced there till,
1:16
nearly 1998.
1:18
And at that point in time, I went
1:20
into the insurance aspect as a dental consultant
1:23
working for Aetna, a life insurance company.
1:26
And I spent eleven years there as their,
1:28
ending my career there as their national dental
1:30
director
1:31
of utilization
1:32
management.
1:34
Following that, I did some time in a
1:36
company up in New York, New York City,
1:39
PNR Dental Strategies,
1:41
and I was the
1:43
national dental director for a national dental insurance
1:47
company called Avisis,
1:49
for a few years. And after that, I
1:51
I was,
1:53
brought on to, the University of Pittsburgh Medical
1:55
Center, UPMC Health Plan,
1:58
back, eleven years ago. So back in 02/2014,
2:02
I started my career here in, UPMC,
2:05
and I've been here,
2:07
since then in a few different roles. But
2:09
my current role is chief dental officer,
2:12
for the health plan, and I'm involved with
2:14
the Medicaid,
2:16
and commercial dental benefits administration.
2:20
Fantastic. So a long career in the dental
2:22
industry and the insurance
2:24
industry, Richard.
2:26
You've obviously then seen a lot about how
2:29
the industries have evolved over the decades. And
2:31
so where I wanted to start with you
2:33
today in terms of our conversation is is
2:35
asking a little bit about, where your role
2:38
intersects with UPMC's
2:40
large footprint.
2:41
Obviously, the health system operates in urban areas
2:44
and and in rural areas as well in
2:46
terms of the patients and the members that
2:48
you serve.
2:49
So I wonder if you could, delve into
2:51
our for our listeners a little bit about
2:53
how you think
2:55
rural dental care is different from dental care
2:58
provided in an urban environment. And I ask
3:00
that because we hear so much today about,
3:03
rural health care access.
3:05
So can you give us your take on
3:06
on what some of the differences there are?
3:09
Yes. Certainly.
3:12
Well, in the urban areas,
3:14
you know,
3:15
access isn't really an issue.
3:17
But when we get out to the,
3:19
more rural areas and the surrounding areas outside
3:22
of, say,
3:23
a metropolis or a metropolitan
3:26
city, finding dentists that, you know, they're very
3:29
difficult to come by, and specialists,
3:32
in particular are even harder to find when
3:34
you need their type of work, like oral
3:36
surgeons or periodontists
3:38
or prosthodontists.
3:40
So
3:41
say let's say for center city of Pittsburgh,
3:44
Pennsylvania.
3:46
We have a dental school within a, you
3:48
know, miles of the downtown area.
3:51
We have many general dentists and many specialists.
3:53
We have hospitals within a stone's throw of
3:56
each other.
3:57
But when you get into a rural area,
3:59
you know, you may have to rely on
4:00
a federally qualified health center,
4:03
that may only have a part time dentist
4:05
as an employee. They may have a full
4:07
time medical staff or even a part time
4:09
medical staff.
4:11
But finding a full time dentist in rural
4:14
areas
4:15
is challenging because
4:17
they're not,
4:18
you know, they're not highly populated.
4:21
There aren't
4:22
many employees that really
4:25
are
4:26
are able to get to those places.
4:29
And, so it's very challenging to find qualified
4:32
people to wanna live and work in rural
4:35
communities.
4:36
So that's one of the biggest challenges that
4:38
we face. And, you know, you may think
4:40
that, oh, we're in the center city of
4:42
Pittsburgh. And but if you go a half
4:44
hour north, southeast, or west,
4:46
you're in an area that's not really a
4:48
dental desert, but it's,
4:51
you're gonna drive or you're gonna have difficulty
4:53
finding a a provider. So maybe,
4:56
you know, those are the challenges right now.
4:58
In the centers of the urban or urban
5:00
areas,
5:01
the having finding dental access isn't really a
5:04
problem. But the further you go out with
5:06
your diameter
5:07
in the radius
5:09
of your circle there, it's, definitely a a
5:12
challenge to find
5:14
quality dental care or dental care in general.
5:17
But,
5:18
finding access is, has been a challenge for
5:21
many of our membership.
5:23
Sure. No. It makes a lot of sense,
5:25
and that really, of course, parallels with, other
5:27
health care services as well in in terms
5:30
of access in rural areas.
5:32
Yeah. Dentistry is not alone in that. So
5:34
Yeah. Certainly.
5:36
So from UPMC's perspective then, how is the
5:39
health system how is the health plan supporting,
5:42
connecting individuals or patients and members in these
5:45
rural areas to better dental services,
5:48
to to more education and support?
5:51
What what's your thoughts there?
5:54
Certainly. We have well, one of the things
5:57
that separates us from some of the other
5:59
plans and, if if they do have them,
6:01
they they they borrowed our ideas.
6:04
We have a clinical team of public health
6:06
dental hygiene practitioners that are strategically located throughout
6:10
our Commonwealth Of Pennsylvania.
6:13
Let's just say we have 14
6:16
public health dental hygiene practitioners, and they're scattered
6:19
in various counties where they have responsibility
6:22
for counties
6:24
that are in close proximity to where they
6:26
live.
6:27
So they'll be contacted
6:29
and connect
6:30
members
6:32
to dentists in those communities.
6:35
So we you know, say in the Northwestern
6:37
Part Of Pennsylvania, we have a a specific
6:40
public health dental hygiene practitioner
6:42
who knows not only the dentists in the
6:45
areas, but knows other resources where they can
6:48
be seen. There's a dental school up there,
6:50
Lee Com Dental School.
6:52
Lake Lake Erie College of Medicine has a
6:54
dental school up in the our Erie area,
6:56
which is located in Northwestern VA.
6:58
And our in our, Western or Eastern areas,
7:01
we have
7:02
Temple University, the Kornberg School of Dentistry, and
7:05
the University of Pennsylvania.
7:07
So we do have access and
7:11
to
7:13
places like that. So UPMC has our hygienists,
7:16
our our public health hygienists
7:18
that can arrange and navigate with the members
7:22
to make sure that they get in to
7:24
see the providers for the care that they
7:27
either need
7:28
specifically or want, you know, if they need
7:30
a tooth taken out or if they need
7:32
a filling.
7:33
So our hygienists are very familiar with the
7:36
providers and the resources within their own community.
7:39
And that seems to be
7:42
a great benefit for us because
7:45
sometimes we have to have a bilingual
7:48
public public health dental hygiene practitioner,
7:51
and they'll be they,
7:53
they'll help their their membership or our members,
7:57
find the provider who can best suit their
7:59
needs.
8:00
A lot of times, they're they'll even go
8:02
above and beyond by, working with those patients
8:05
or our members
8:07
to find transportation
8:08
to get them to the places that they
8:10
need. Because one of the other issues in
8:12
rural
8:13
Pennsylvania
8:14
is lack of consistent access
8:17
by transportation.
8:19
You know,
8:20
depends on weather. It depends on
8:22
a multiple
8:23
of things.
8:25
But, so those are things those are some
8:27
of the benefits that we have by employing
8:30
our public health dental hygiene practitioners.
8:32
They really know their their communities, and they're
8:35
able to connect our members with the providers
8:37
who best serve their needs.
8:40
Understood. So, really, a whole host of challenges
8:43
that can make getting access in this type
8:44
of health care difficult, it sounds like.
8:47
Certainly.
8:48
Any other resources you would share in terms
8:51
of,
8:52
what is available to individuals living in these
8:54
areas or any new trend you're seeing in
8:57
the dental benefits industry, Richard, that you think
8:59
is really helping expand access to to more
9:02
dental care.
9:03
Yes. I what I do see and
9:06
are are trends in,
9:09
certainly, in the education aspect of it. They're
9:12
doing more counseling on nutrition.
9:16
Smoking cessation's a big item for,
9:19
for us to cover when we deal with
9:21
our patients and have members that have, you
9:24
know, they're trying to to quit so we
9:26
can provide them with resources or even case
9:29
managers
9:30
to get them the resources that they need
9:31
for those types of things.
9:34
So education is certainly key. What we're trying
9:37
to do is prevent
9:39
the need for dental services by, you know,
9:42
applying sealants to children,
9:45
other, there are other
9:47
materials that can be applied to teeth. Hydroxyapatite
9:50
is one that's another
9:52
decay preventing measure, silver diamine fluoride,
9:56
which helps stop decay.
9:59
So
10:00
that's one of the key
10:03
keys to our success is by having our
10:05
hygienists
10:06
and other
10:08
oral health care professionals
10:10
be able to provide those types of resources
10:13
and those, you know, either through
10:15
demonstrating proper brushing and flossing techniques,
10:19
applications of silver diamine or so of topical
10:22
fluoride,
10:23
and,
10:24
different things like that to help make people
10:27
more aware
10:28
and make them a better
10:31
partner in taking care of their teeth because
10:34
you just can't visit a dentist twice a
10:36
year and think that everything's gonna be great.
10:38
It takes some work on the patient's part
10:41
to maintain that. So you come to see
10:43
the professionals once or twice a year, and
10:45
then and sometimes our our population can't get
10:48
to the dentist once or twice a year.
10:51
So we have to end up going into
10:52
the communities and trying to address their needs.
10:55
And we do that with certain,
10:58
events, and certain providers go out into our
11:00
communities and have what we call pop up
11:03
events
11:04
where people can be brought into either
11:07
a a local facility like a church or
11:09
a library or a VFW
11:12
or something like that, and they can receive
11:14
some dental services that way. So we are
11:17
very fortunate to have a few doctors who
11:19
who do
11:21
the portable equipment to different locations throughout our
11:24
Commonwealth,
11:25
and that really helps increase our access. But,
11:27
ideally, we'd like to have everybody assigned to
11:30
a dental home
11:31
so they can get consistent treatment
11:34
and, receive the services that they need when
11:36
they need them.
11:38
Understood. So a pretty multi pronged strategy here
11:40
from the APMC, Richard, it sounds like, from
11:43
education resources,
11:45
to allocation of of physical tools,
11:47
to to clinic.
11:50
Yes. It it definitely is a multi pronged
11:52
strategy and approach. We need not just,
11:56
our dental hygiene practitioners, but we need every,
11:59
health care provider in our community.
12:02
We have our providers,
12:03
our pediatric
12:05
dentists that are very
12:07
important in this
12:09
in this equation or this approach because
12:12
many of them are the ones that our
12:14
public health dental hygiene practitioners refer to. And
12:17
even the we have public health dental hygiene
12:20
practitioners in the pediatricians' offices, and that helped
12:24
or not in all of them, but in
12:26
many of them.
12:27
And that really helps us to,
12:29
to get patients when they're in there for
12:31
their wellness checks. We can get some dental
12:34
services in there and check the teeth.
12:36
So it's involving a, you know,
12:40
multifaceted
12:42
oral health care approach.
12:44
And you have to understand how dentistry and
12:47
medicine are integrated. I mean, there is a
12:49
dental medical integration.
12:51
And so, you know, the saliva that we
12:53
have in our mouths, how that starts the
12:56
digestion process and things like that. And so
12:59
the mouth is the gateway to to
13:01
health, and that's really where we want to
13:04
we focus on. So as a dentist, that's
13:06
our first place to look and to see
13:08
if there's any can we identify anything that
13:11
may be going on systemically?
13:12
You know? You can tell, you know, bleeding
13:15
gums, and that may be a sign of
13:17
another condition.
13:18
And, many times, the dentist is the first
13:21
person to see that patient to say, hey.
13:23
You know you know you have bleeding gums
13:25
here. Do you know why?
13:27
And then if they don't know why and
13:28
if it's not,
13:29
you know, related to an oral health condition,
13:32
then that's where you engage them with their
13:35
primary care physician or a specialist.
13:38
So, you know, there's various things that happen,
13:41
and that's why it's so important to
13:43
be seen by a dental provider and oral
13:46
health care providers,
13:47
routinely.
13:48
We try to avoid having,
13:50
unnecessary
13:52
stays in hospitals or unnecessary visits to, urgent
13:55
centers
13:56
for two, three related issues. So if you
13:59
know, my advice to everybody would be to
14:02
see a dentist, you know, and certainly as
14:04
often as you can
14:06
and,
14:07
mitigate the circumstances,
14:09
you know, take take heed of the education,
14:13
learn from the counseling that's provided, you know,
14:15
maybe stop some
14:17
of the habits, smoking,
14:19
other things like that, vaping, chewing. And, it's
14:22
best to do that with the younger
14:25
at least we found better success with younger,
14:29
population students.
14:31
You know, maybe some peer pressures kicked in
14:33
where they wanna try smoking or vaping and
14:35
things. So it's important for us as health
14:37
care professionals to show them
14:39
the, the negative
14:41
sides of or, you know, what the bad
14:44
what's bad that can happen by prolonged
14:47
chewing or smoking, things like that. So trying
14:50
to educate and prevent is really the, two
14:53
of the major
14:54
points here at UPMC Health Plan that we
14:56
like to
14:58
make sure that we communicate to our membership.
15:01
Certainly. Certainly. Well, I I really appreciate all
15:03
the details here, Richard. And I also wanna
15:06
ask if there's any other initiatives,
15:08
programs of note from UPMC regarding expanding access
15:12
to dental care, that that you think are
15:15
worth highlighting.
15:17
Yes. Thank you.
15:20
Coming up is a, a really great event.
15:23
It's the, Mission of Mercy at Pittsburgh,
15:26
and that would be October,
15:28
and it's held at the David Lawrence Convention
15:30
Center here in Downtown Pittsburgh.
15:33
It's basically a two day
15:35
free dental clinic, but there's also other health
15:38
care services that are offered, which include,
15:41
eye care and hearing. So,
15:45
many local sponsors get together, including UPMC Health
15:48
Plan, which is a premier sponsor of the
15:50
event,
15:52
where patients can not only receive dental care
15:54
if, you know, whatever they need. We do
15:56
everything from planings to fillings to extractions
15:59
to small partial dentures, what we call flippers,
16:03
replacing one or two teeth. We don't do
16:05
complete or full dentures,
16:08
or major root canals, like third molar root
16:10
canals or, you know, molar root canals in
16:13
general. But we do a lot of extractions
16:15
because
16:16
and,
16:18
there's also the hearing in the eye, so
16:20
we give away
16:21
eyeglasses
16:22
to those that are eligible
16:26
and hearing aids. So this is all free.
16:28
There's no insurance
16:29
information gathered
16:31
other than a name and some of the
16:33
basic
16:35
needs such as name and weight and things
16:37
like that to make sure that we administer,
16:40
if we need to, proper amounts of anesthetic.
16:43
So that's the one
16:45
thing that's coming up. And there are other
16:46
events in the area, which are like the
16:49
regional area medical events such as the remote
16:52
area medical. Those are usually held in the
16:54
summers, and we just had one a few
16:56
months ago.
16:57
But, we do support those types of things.
17:00
We have employees that, volunteer.
17:03
And, here at UPMC, we're probably gonna have,
17:08
oh, I don't know. We'll probably have a
17:10
thousand volunteers in total for this our Mission
17:12
of Mercy here in in two weeks in
17:15
October.
17:17
But,
17:18
it's a wonderful event. And if, you know
17:20
of anybody who's interested in volunteering, please just
17:23
have them go to our
17:24
mompgh.0rg
17:27
website to, find out further information and details
17:30
as to how to,
17:31
become part and active with our, our mission
17:34
to Mercy, but it's a wonderful event.
17:37
Fantastic. Well, it's so great to hear how
17:39
UPMC is sponsoring and supporting efforts like this,
17:42
Richard. So I appreciate you sharing with us.
17:45
Before we go, you've got the ears of
17:47
a lot of other health plan and dental
17:49
leaders
17:50
from all over the country right now. So
17:52
I'm wondering if you could take a minute,
17:54
is there any any final thoughts with them,
17:56
any tidbits of advice you wanna offer as
17:59
as they do continue to navigate this business.
18:02
Anything you would share.
18:06
Yeah. Thank you. And,
18:08
I'd just like to
18:10
ask my colleagues and everybody out there just
18:12
to understand how
18:14
how the situations of the world impacted
18:17
dentistry. You know, we had we went through
18:19
an epidemic
18:20
or a pandemic there, and,
18:22
that really impacted
18:24
the needs of dental practitioners
18:27
as well as the patients.
18:29
So I I appreciate my colleagues and everyone
18:31
in our space
18:32
that's doing what they can to get the
18:34
patients who had to
18:36
not be able to seek treatment during the
18:39
that pandemic
18:40
and getting them in and
18:42
taking care of the diseases that were unable
18:45
to be addressed
18:46
during that time. So I wanna offer my
18:49
sincere thanks to everybody in our,
18:51
my profession and all the health care professions
18:54
for doing what they can to, finally get
18:57
caught up and,
18:59
get patients in in timely fashions
19:01
and address the needs that probably got worse
19:04
since there was lack of access during that
19:07
pandemic period. But as the
19:10
pandemic worn, wore down and the you know,
19:13
now that offices are open again and things
19:15
like that,
19:17
I just, appreciate everybody's
19:20
input and how they've come together to make
19:23
sure that the patient's needs get addressed
19:26
timely and,
19:27
appropriately. So I couldn't be more proud to
19:30
be a dentist at this point in time,
19:32
and I'm proud to work with a lot
19:34
of the colleagues, not only here at UPMC
19:36
Health Plan, but throughout the state, Pennsylvania,
19:39
and across the nation. I have friends and
19:41
colleagues,
19:42
across the country,
19:43
and, they do great work. And I just,
19:46
I'm proud to be associated with each and
19:48
every one of them. So
19:50
that's where it is. Wonderful. I think that's
19:52
a great place to leave things. So, doctor
19:54
Salfour, I wanna thank you for taking the
19:56
time to chat with us and for sharing
19:58
your insights with our audience. We really appreciate
20:00
it.
20:01
Jacob, thank you for the opportunity.
20:03
Absolutely. And to our listeners, if you'd like
20:05
to listen to more podcasts from Becker's Health
20:07
Care, you can visit beckershospitalreview.com.