How 1 payer is approaching a 'paradigm shift' in dentistry

MetLife is helping to set the stage for more insurers to offer value-based dentistry services with its new program.

The company recently launched SpotLite on Oral Health, a new preferred dentist program that rewards providers for quality of outcomes instead of quantity of care delivered. Employees are able to use the insurer's search engine tool to connect with a designated dental provider, who are verified through a proprietary evaluation process.

Chief Dental Officer Peter Fuentes, DMD, recently spoke with Becker's to discuss MetLife's new initiative and the importance of value-based dentistry.

Editor's note: Responses were lightly edited for clarity and length.

Question: What made MetLife want to provide this service?

Dr. Peter Fuentes: Value-based healthcare is the future of healthcare. In fact, the number of value-based programs in the U.S. is expected to double in the next five years. MetLife took this approach and applied it to the evaluation of dental providers to strengthen our network and enable an increased emphasis on supplying access to designated providers who focus on quality health outcomes. This new program provides a fair and equitable evaluation of qualifying in-network dentists and not only helps employees locate SpotLite dentists, but given its focus on improving oral health outcomes, also helps employers reduce costs and improve holistic wellness across their workforces.

Q: What kind of results is the company hoping to see for employees who take advantage of the program? How about the providers who participate?

PF: We know that delaying dental care can increase the need for more advanced and expensive dental care later down the road. Conversely, preventive care can improve employee health outcomes, reduce disease and limit future risk. The program was intentionally designed to help employees find a dental care provider who has their long-term health interests in mind. Employees can easily find the right SpotLite dentist for them through our Find a Dentist search engine tool and feel confident they will meet with a provider who is focused on preventive care. As a result, this recognition helps providers stand out compared to their peers.

Q: How many providers will be participating in the program?

PF: There are qualifying providers at 46,000 locations, which includes general and pediatric dentists. To qualify, dentists must add value for patients through quality, cost-effective services that focus on improving long-term and holistic health through measures such as leveraging proactive and preventive care and other qualifying factors. It’s important to note that all participating dentists in MetLife’s network undergo a rigorous credentialing and selection process and that MetLife’s SpotLite on Oral Health is a special recognition awarded to dentists annually.

Q: You mentioned that MetLife is one of the first commercial carriers to offer value-based dentistry. What do you think has prevented other carriers from doing this?

PF: Value-based approaches represent a paradigm shift in dentistry. Historically, providers have been rewarded by procedure volume and complexity, and many carriers still follow this standard approach. But there’s power in providing individuals with information needed to find a dental team that aligns to their health goals, supporting their well-being. Value-based programs recognize and reward providers for the quality of health outcomes rather than the volume and complexity of procedures. In turn, this helps individuals achieve and maintain the highest possible level of wellness.

Q: Do you think other carriers could begin offering value-based dentistry now that MetLife has helped set the stage for this? 

PF: Value-based healthcare is certainly growing in popularity and adoption, and it’s very possible that more carriers will begin offering value-based dentistry in the coming years. It also just makes good business sense: Providing access to qualifying dentists means improved health for employees, in addition to increased value for employers and reduced costs over time. Offering employees programs that improve oral health outcomes also allows employers to better demonstrate employee care — something our research shows drives employees’ holistic health, as well as business outcomes like employee engagement and productivity. 

Q: Now that MetLife has entered value-based healthcare, how else does the company plan to expand on this initiative?

PF: Right now, our network is stronger than ever, and we are continuing our work to provide employees with designated providers who focus on quality health outcomes. MetLife continues to explore value-based approaches in other ways to deliver the best offerings for employers, employees and providers. In the future, dentists awarded the SpotLite designation may be eligible for enhanced service packages and other benefits. Value-based programs will continuously evolve to increase satisfaction in network participation.

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