Insurers1 August, 2023

Why AI is Essential to Whole Person Health Initiatives

Why AI is Essential to Whole Person Health Initiatives

Insurers1 August, 2023

The concept of “whole person health” is gaining momentum today because it’s based on a fundamental truth: that physical, emotional, and social wellbeing are all connected. But in reality, it is not a new concept. 

In 1948, The World Health Organization defined health “as a state of complete physical, mental and social well-being”*, acknowledging the imperative existence of health beyond just the physical body. While there is increasing attention on mental health and caring for our physical bodies, it is crucial to acknowledge the profound impact of oral health on our overall well-being.

“There’s a growing body of evidence about the relationship between oral and systemic health.”

Dr. Teresa Dolan, Chief Dental Officer, Overjet

According to the Centers for Disease Control and Prevention (CDC) data from 2021 revealed that 82% of adults had visited a medical professional in the past 12 months, while only 64% sought dental care*. This glaring disparity highlights a significant disconnect, both among individuals and healthcare professionals, regarding the crucial correlation between medical and dental health, and its transformative potential in enhancing overall health.

Insurers are Paving the Way in Medical–Dental Integration

Dental Insurers are playing a critical role in acknowledging how crucial medical and dental integration is to improving the overall health of members. Insurers are actively seeking innovative ways to partner with health systems to improve health equity and improve access to care through a range of initiatives to improve member health. A few are diving in to understand the full spectrum of how improving oral health and access to dental care can help members reach their fullest health potential.

Leading dental insurers have played a pioneering role in conducting impactful studies and publishing research highlighting the positive effects of preventive dental care on member health and quality of life. In a groundbreaking study conducted in 2014*, it showed that simple, noninvasive periodontal therapy can improve health outcomes during pregnancy. Investigations have also been done on how the inclusion of dental benefits for patients with chronic health conditions leads to significant reductions in overall healthcare expenditures and improved outcomes.*

Dr. Teresa Dolan, Chief Dental Officer at Overjet, states, “There’s a growing body of evidence about the relationship between oral and systemic health. Recently, there have been some interesting insurance studies showing that if individuals are provided with a simple cleaning benefit, overall healthcare costs go down, specifically with patients with diabetes, coronary artery disease or both. We’re still studying the causality, but we believe it has to do with the inflammatory process. If dental providers can minimize the inflammatory burden on individuals, it improves their overall health.”

As insurers continue to prioritize whole person health, how can partnering with artificial intelligence propel the groundwork to enable integrated, patient-centric care?

Advancing Oral Health Innovation through AI Partnerships 

Artificial Intelligence (AI) empowers dental insurers to supercharge their whole person health initiatives. Collaborating  with AI partners like Overjet enables insurers to elevate their strategies and integrate oral healthcare for overall well-being effectively. AI drives innovation, ensuring comprehensive care and optimal health outcomes.

Overjet revolutionizes oral health and comprehensive care in collaboration with insurers through key initiatives:

  1. Overjet promotes an integrated ecosystem for better patient care: An extensive network of payers and providers now leverage the power of artificial intelligence, serving to unify the dental care ecosystem. Through this advanced platform, patients benefit from a precise and streamlined process that spans the entire healthcare journey. With AI-driven networks and robust partnerships, continuity of care is ensured as patients seamlessly transition between dental providers and insurers. Both parties have access to the same comprehensive data, including submissions and radiographs, ensuring a consistent and unified approach and reliable patient communication.

  2. Overjet empowers preventative care: By utilizing advanced technology to analyze radiographs submitted by providers, Overjet enables clinical reviewers to evaluate the entire mouth, providing a comprehensive understanding of the patient’s oral health. This holistic approach helps avoid making isolated decisions on individual teeth that may not require treatment, but instead consider the broader context of the patient’s overall oral health. By reducing unnecessary treatments and promoting preventative care, Overjet facilitates cost-effective and patient-centered approaches to oral healthcare.

  3. Overjet facilitates chairside adjudication: This empowers patients to make informed financial decisions about their care directly at the point of service, leading to improved treatment acceptance. By providing transparent claim coverage information, Overjet enables patients to understand their insurance coverage and make confident choices, reducing the likelihood of skipping necessary care that could potentially lead to future complications. In essence, Overjet’s chairside adjudication fosters a seamless patient experience, ensuring timely access to essential treatments while promoting long-term oral health.

  4. Overjet enables fraud, waste, and abuse detection: Overjet helps dental insurers identify potentially fraudulent claims by analyzing provider submissions with AI and detecting patterns, repeat submissions, and inappropriate claims. By detecting potentially unnecessary procedures, Overjet facilitates a comprehensive approach to care. Patients should only undergo medically necessary treatments, and the identification of non-essential procedures prompts a second review, ensuring patients receive appropriate and essential care. This proactive approach helps foster trust in oral health providers, prevents future skipped dental visits, and reinforces the importance of whole person care, ensuring patients receive the treatments they truly need for their overall well-being.

Artificial intelligence (AI) serves as a vital partner for dental insurers in their pursuit of improving whole person health. By facilitating seamless care coordination, providing education to individuals and providers, improving treatment acceptance, and detecting fraudulent activities, AI instills trust in the dental industry and encourages patients to invest in their oral health. With AI as a trusted ally, dental insurers can make significant strides in enhancing whole person health outcomes and fostering a holistic approach to healthcare.