Premera Program Reaching Out to High-Risk Members in Need of Dental Exams

In recognition of the mounting scientific evidence linking incidence of periodontal disease with increased health risks for members with diabetes and heart disease, Premera Blue Cross’s newly launched education and outreach campaign that encourages previously identified high-risk members to schedule a dental check-up has already achieved a nearly 20 percent success rate in this initial phase.

Of the 2000 targeted members with medical and dental coverage who also participate in Premera’s diabetes and heart disease care management programs, more than 350 of them visited their dentist within 90 days of being sent a letter. In turn, about 30 percent of those members had indeed required periodontal services.

“By having both Premera dental and medical coverage, Premera was able to compare claims data to identify members receiving care management services for diabetes and heart disease who had not seen a dentist in the past 12 months. If the members had their dental or medical coverage at different companies, Premera would not have been able to have identified them,” said Charles Brody, Premera’s Director of Dental Plans. “This difference in intervention time can clearly make a difference on the members’ overall health.”

To help the members find an in-network dentist, the letters provided them with Premera’s dental website (www.premera.com/dentalhealth) as well as reminded them of the company’s customer service number (800-722-1471).

In addition to the studies on diabetes and heart disease, other researchers have examined the potential impact of periodontal disease on high-risk pregnancies. According to the American Academy of Periodontology, women with severe gum disease are up to 7 times more likely to have a premature, low-weight baby. In response, Premera’s care management services are contacting high-risk maternity members separately.

“Not only do our members benefit by staying healthier, their employers benefit by us offering preventive health steps and helping them to avoid potential lost productivity and higher health costs. We believe that this program and all of Premera’s prevention measures will help reduce everyone’s overall health care costs over time,” said Brody.

In addition to the letter, an enclosed brochure provided a description of the link between good dental/periodontal health and one’s overall health. It also referenced the Premera website, which has more detailed information on the studies as well as information from and links to sites such as the American Heart Association, American Dental Association, National Institutes of Health and American Academy of Periodontology. The Premera website also provides members with more information about dental health, these three medical conditions and many others.

The decision to launch a program matching members with these three medical conditions was made in recognition of the mounting evidence in the peer reviewed dental, periodontal and medical literature, said Brody. Studies consistently estimate that between 50 to 75 percent of American adults have some form of gum disease. Given this relationship, Premera is committed to providing dental programs that include comprehensive dental benefits and which encourage members to be proactive in attaining their preventive dental care, he said.

About Premera Blue Cross

Our mission is to provide peace of mind to our members about their health-care coverage. We provide health care coverage and related services to more than 1.3 million people. Premera Blue Cross has operated in Washington since 1933, and Alaska since 1952. Premera Blue Cross is an independent licensee of the Blue Cross Blue Shield Association. Premera Blue Cross is a member of a family of companies based in Mountlake Terrace, Washington, that provide health, life, vision, dental, and long-term care insurance, and other related services.