Dental care is not immune to the wave of rising costs that has hit other sectors of the health care industry. In an effort to contain those costs, insurance providers have increasingly turned to capitation plans (CAP), which shift the costs of care to the dentist, rather than fee-for-service plans (FFS), wherein costs are shifted to the patient. How do the two types of plans differ in terms of their effect on patient behavior and perceived level of care? This report gauges how people rate their plans and their oral health through a bivariate and multivariate analysis of the results of a survey submitted by 2,340 respondents--57.7 percent of them in FFS plans and 42.3 in CAP plans. The authors analyzed several variables, including income, out-of-pocket-costs, and demographic categories, that gave rise to significant differences in perceptions of oral health, satisfaction with plan, and satisfaction with dentist. The authors conclude by noting that a general dissatisfaction exists with CAP plans as compared to FFS plans.
From the Publisher
This report presents results from the RAND study of enrollees in capitated and fee-for-servicedental benefit plans. The objectives was to investigate the differences in the behavior andattitudes of the enrollees within the two types of plans.Eight "Fortune 500" companies were selected for the study with dental benefit plans. California,Michigan, New Jersey, and North Carolina were chosen as sites for the study. These four statesrepresent varying levels for the development of managed care plans in dentistry and therefore,four distinct dental markets. The premium paid by the enrollees and their out-of-pocket costsalso varied.These variations allowed us to compare companies, dental markets, plan types, and economiccosts to the enrollees. The enrollee's behavior and attitudes were measured by their use of dentalcare, their experience with the dental plan, satisfaction with their dental plan, satisfaction withthe dentist, and their perceived oral health status.This report presents the results of our analysis. The findings should be of interest to both thoseenrolled in dental plans and those involved in establishing such plans for corporations. They willalso be of interest to those reimbursed by the plans for professional services, the dentists.The work was conducted by a joint team from RAND and from the UCLA School of Dentistry,Division of Public Health and Community Dentistry.
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