The index is compiled from a subset of the Change Healthcare client database, which analyzed more than 30,000 in-network insurance claims in the U.S. over a 12-month period.
Varying dental plans are creating higher out-of-pocket costs for patients, making the market for dental services more consumer-driven, according to Change Healthcare. These concerns are creating an alarming trend, the company noted: Employees and their dependents are skipping regular visits and neglecting dental care.
Women were more likely to receive dental care, averaging 1.31 visits per year versus only 1.11 for men, the index found. Seniors age 60 and older were also the most likely to receive dental care, compared with young adults ages 21 to 30 representing the least likely.
The Healthcare Transparency Index also revealed considerable price disparities and local savings potential for the most common dental services, including adult and pediatric preventive exams with and without x-rays, adult caries repair, application of braces with pre- and follow-up visits, and third-molar removal with sedation or anesthesia. Amounts for dental services could vary by more than 400% in the same area for the same service, according to the index.
Among the index's other findings:
- With cost now a significant barrier to proper care, the index found that the same preventive exam for adults could cost as much as $240 and as low as $55 in the same area, and pediatric exams ranged from $180 to just $35.
- Claims data indicated that caries repair at the high-end could cost as much as $360, making these services unattainable for many and leading to long-term health issues, according to Change Healthcare.
- The index reported a high of $6,960 for orthodontic services (including a previsit, braces application, and follow-up visit), compared with a low of $2,400 in the same area.
The index also uncovered other trends regarding dental utilization rates. The data indicated there was a steady decline in dental visits in each quarter, with 38% of all services occurring in the first quarter and trailing to only 16% in the fourth quarter. This is in stark contrast to the medical industry, in which claims typically increase toward the year-end.
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