During the last American election cycle, a main source of contention and debate was the future of healthcare policy in the United States. Republican candidate—and now President-elect—Donald Trump has shared his goal of repealing and replacing the Affordable Care Act (ACA). The impact of this change on public health is uncertain, however, one major healthcare issue that is largely left out of the conversation is the state of oral health in America. It is likely that dental care coverage will be affected with changes to health policy, which will impact patient access to oral health care services. In addition, changes will also be felt by the dental industry, as restricted patient access to services will trickle down to influence the US dental device markets.
Dental care is often regarded as an elective, non-critical health issue, yet lack of dental care is linked to significant health issues; dental disease has major implications for the rest of the body. For example, periodontal disease is a risk factor for cardiovascular disease, diabetes, and Alzheimer’s disease; and dental infections have also been associated with pneumonia.
Under current federal legislation, pediatric dental care is deemed essential under most insurance plans, yet given that dental care insurance is often sold separately from other forms of health care, many children do not receive appropriate coverage. In fact, the American Dental Association states that only 37.2% of children receive dental benefits through Medicaid/the Children’s Health Insurance Program, 49.7% have benefits through private insurance, and 13.2% do not have any dental benefits at all. The coverage is even worse for adults, where only 10.1% have benefits through Medicare, and 34% do not have any dental benefits; for seniors, 63.9% do not have any dental benefits.
However, under the ACA, the Health Policy Institute of the American Dental Association predicted that the number of adults eligible to receive coverage through Medicaid could increase to 51.9%; furthermore, it was predicted that by 2018, coverage could expand to include up to 3.2 million children and 4.5 million adults. Given that dental care has largely been paid for out-of-pocket by adults, this expanded coverage could reduce the burden of cost and permit more adults and children to access dental services, effectively boosting preventative healthcare and decreasing the likelihood of further disease in the future.
Although it is too early to make definitive statements surrounding the future of the ACA and its potential replacement, there is a possibility that these promising figures will never be realized, or at the very least, will be dampened. As a result, dental care may remain unaffordable for a large proportion of the American population.
How will dental device manufacturers fare if changes to the ACA reduce dental coverage for Americans? Given that dental services are primarily elective and usually paid for out-of-pocket, dentists therefore face strong pricing pressures to offer services to patients at lower costs. This, in turn, forces dental device manufacturers to offer low-cost device solutions to remain competitive. This trend is readily apparent in the dental-implant markets, where premium dental implant companies are acquiring value-based dental implant manufacturers in order to offer more flexibility on price. This trend is likely to continue and to become more prominent in other dental markets.
Sources also indicate that increased pricing pressures on dentists may shift the practitioner landscape. For example, it is suggested that in the future, less-specialized technologists, rather than dentists, will be perform dental imaging and diagnostics, which will reduce patient fees for these services. This, in turn, will impact dental device manufacturer marketing strategies, whereby manufacturers of imaging devices will need to target technologists instead of dentists, and create customized technologist training programs to foster brand loyalty for their products.
Ultimately, dental device manufacturers will be forced to place more emphasis on cost-savings for patients and dentists; which may mean investing in greater clinical research to demonstrate the value and endurance of their products.
Although the future of the ACA and the resulting impact on dental care coverage remains uncertain, should benefits be reduced, dentists and device manufacturers will undoubtedly continue to feel the effects of pricing pressures, which will place more emphasis on value-based care and low-cost device solutions in the dental health world.
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