Using Technology to Recognize Great Providers and Improve Medicaid Benefit Admin

Recently, I had an opportunity to make a presentation on how technology enables happier, more engaged networks at the 2018 American Academy of Pediatric Dentistry (AAPD) Annual Conference. I was grateful to be invited to speak with so many pediatric dentists from all over the U.S. about how payers are starting to use big data analytics and other technology-enabled solutions to improve dental provider engagement within their networks. It was also exciting to see how interested everyone seemed to be in the topic. Two areas in particular drew the most comments and questions.

Provider Rating and Recognition Program

This was by far the hottest topic of discussion. SKYGEN is using the big data that payers already have to compare dentists to their peers within their markets to identify the highest-performers so they can be recognized for their excellence. Recognition can take many forms, including higher reimbursement schedules, having their information appear at the top of “find-a-provider” listings for their geographical area, “Top Provider” badges for their website, plaques or certificates for the office, etc.

It doesn’t have to be a zero-sum game with payers and providers. By partnering, and using the technology-enabled solutions that are available to them, both payers and providers can be better stewards of program dollars – leading to higher reimbursement for providers and a better overall experience for patients. Most of the dentists in attendance appeared to be excited by the idea. They liked knowing that payers are interested in partnering with them and being recognized for high quality work. Some lauded SKYGEN for bringing a focus on technology to the dental world, but seemed uncomfortable with the idea of being compared to their peers. Explaining the rating criteria, however, seemed to allay most of the concerns.

Medicaid Dental Services

The other hot topic was how technology can solve many of the issues that might otherwise deter pediatric dentists from participating in the Medicaid program. One good example is dentists who work with multiple Medicaid payers within their state. Technology can help them manage those nuances, and relieve the administrative burden (and cost) so they have more time and money available to deliver quality care. Ultimately, payers want to partner with providers. Every efficiency we develop to bring payers and providers together helps keep more dollars in the program, which enables more and better care to be delivered.

Looking Ahead

While this group of dentists was aware that technology-enabled solutions exist, many seemed surprised by the scope of what is available to them. As we continue moving forward, it will be exciting to see more and more providers taking advantage of the tools that are available to them – and the positive effects these tools can have on pediatric dentistry as a whole.