A Claims-Based Study of Utilization of Dental Services among Adults 65 and Older

10:00AM - 11:15AM CT
presented by FAIRHealth

Adults age 65 and older may have greater dental needs and could spend more on dental care than other age groups, yet 70% lack dental coverage, and many lose their dental insurance after retirement. Furthermore, Medicare does not cover or reimburse many routine dental services. High out-of-pocket costs and a lack of price transparency impede timely dental care for seniors. In 2018, more than half of adults age 65 and over in the United States reported that they had not visited the dentist in the past year, owing primarily to financial barriers. Without routine preventive dental services (e.g., dental cleanings), older adults can experience poor oral health and, concomitantly, poor general health. Untreated dental issues likewise can lead to increased usage of emergency departments (EDs); over 2 million individuals visit the ED for dental pain each year.

Drawing on the nation’s largest repository of private healthcare claims data, this session will present a claims-based analysis of utilization of dental services among adults 65 and older. The analysis will:

  1. examine trends in the utilization of preventive dental services and treatments among adults and compare them to those age 65 and older,
  2. identify trends in ED visits pertaining to dental diagnoses among this population compared to other age cohorts and
  3. explore trends in the dental claims data for older adults by gender.
In particular, the session will illuminate the decline in preventive services during the COVID-19 pandemic in adults age 65 and older, and compare it to the decline in younger age cohorts. Individuals at risk of severe cases of COVID-19 were targeted for emergency dental care.

Robin Gelburd, JD
President of FAIR Health

Robin_Gelburd.pngRobin Gelburd, JD, is the President of FAIR Health, a national, independent nonprofit organization with the mission of bringing transparency to healthcare costs and health insurance information. FAIR Health possesses the nation’s largest collection of private healthcare claims data, which includes over 31 billion claim records contributed by payors and administrators who insure or process claims for private insurance plans covering more than 150 million individuals. Certified by the Centers for Medicare & Medicaid Services (CMS) as a national Qualified Entity, FAIR Health also receives data representing the experience of all individuals enrolled in traditional Medicare Parts A, B and D; FAIR Health includes among the private claims data in its database, data on Medicare Advantage enrollees. FAIR Health licenses data and data products to businesses, hospitals and healthcare systems, government agencies and researchers. The company also uses its database to power a free, award-winning website that enables consumers to estimate and plan for their healthcare expenditures, as well as learn more about healthcare reimbursement. Robin is a nationally recognized expert on healthcare policy, data and transparency. A recipient of a 2016 Dig|Benefits Technology Innovator Award, bestowed by Employee Benefit News, she has been invited to speak to organizations across the country on topics of critical importance to employers, employees, healthcare professionals and institutions, health plans, third-party administrators, consultants, researchers and other healthcare stakeholders. She also has published numerous articles on topics such as data analytics and quality, healthcare cost transparency, and consumer engagement and protection, among many others. Prior to being recruited as president of FAIR Health, Robin served for eight years as General Counsel of a medical research foundation comprising approximately 30 premier academic medical centers, hospitals and research institutions in New York. Before becoming General Counsel, Robin was a health law partner at a New York City law firm representing a broad array of healthcare-based clients. Earlier, Robin worked as a litigation and corporate associate at the international law firm Morrison & Foerster. She began her legal career as a federal appellate law clerk to the Honorable Francis D. Murnaghan, Jr., from the Court of Appeals, 4th Circuit.


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