In the U.S., benefit or insurance designs are dichotomized into Commercial and Governmental systems. The utilization and spending design of both commercial and Medicaid dental insurance is shaped by financial incentives that create business and care models influenced by revenue collection, risk pooling, purchasing, and level of social empathy. The cumulative effect produced a focus disease stabilization over disease prevention. In this course, we will discuss opportunities with a prevention based operations to bridge the gap between the current commercial and public dental insurance provider networks.
• Objective 1: Discuss the differences and similarities with care delivery for private and public insurance participants.
• Objective 2: Describe spending and utilization for commercial and governmental dental care plans.
• Objective 3: Identify opportunities for dental care organizations to diversify their patient population by bridging the public, private divide.
Sean G. Boynes, DMD, MS, serves as vice president, health improvement for CareQuest Institute for Oral Health. Sean leads the organization’s health improvement programs, partnering with public and private stakeholders across the health continuum to develop, test, and measure prevention-focused, person-centered strategies.
A dentist anesthesiologist and prolific author and speaker, Sean is a catalyst for systems change – testing ideas and identifying solutions to create a more equitable, accessible, and integrated health system, especially for historically marginalized people and communities. He spearheads several initiatives, including national programs that promote the integration and coordination of person-centered care, the development and implementation of value based oral health strategies, and the establishment of meaningful oral health measurement to evaluate success.
Sean has been recognized by a number of national organizations for his work in health policy and clinical care. Recognitions include: National Health Service Corps’ 40th Anniversary Celebration 40 Top Clinicians award, Distinguished School Services Award from the South Carolina School Nurses Association, Dentist of Distinction designation by the National Children’s Oral Health Foundation, and the National Network for Oral Health Access President’s Award.
Sean earned his doctor of dental medicine degree from the University of Pittsburgh and completed a three-year residency in anesthesiology from the University of Pittsburgh Medical Center.