Insurer views on reimbursement of preventive services in the dental setting: results from a qualitative study.

Abstract:

OBJECTIVES:We explored insurers' perceptions regarding barriers to reimbursement for oral rapid HIV testing and other preventive screenings during dental care. METHODS:We conducted semistructured interviews between April and October 2010 with a targeted sample of 13 dental insurance company executives and consultants, whose firms' cumulative market share exceeded 50% of US employer-based dental insurance markets. Participants represented viewpoints from a significant share of the dental insurance industry. RESULTS:Some preventive screenings, such as for oral cancer, received widespread insurer support and reimbursement. Others, such as population-based HIV screening, appeared to face many barriers to insurance reimbursement. The principal barriers were minimal employer demand, limited evidence of effectiveness and return on investment specific to dental settings, implementation and organizational constraints, lack of provider training, and perceived lack of patient acceptance. CONCLUSIONS:The dental setting is a promising venue for preventive screenings, and addressing barriers to insurance reimbursement for such services is a key challenge for public health policy.

journal_name

Am J Public Health

authors

Feinstein-Winitzer RT,Pollack HA,Parish CL,Pereyra MR,Abel SN,Metsch LR

doi

10.2105/AJPH.2013.301825

subject

Has Abstract

pub_date

2014-05-01 00:00:00

pages

881-7

issue

5

eissn

0090-0036

issn

1541-0048

journal_volume

104

pub_type

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