Insurer views on reimbursement of preventive services in the dental setting: Results from a qualitative study

Rebecca T. Feinstein-Winitzer, Harold A. Pollack, Carrigan L. Parish, Margaret R. Pereyra, Stephen N. Abel, Lisa R. Metsch

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Objectives. We explored insurers' perceptions regarding barriers to reimbursement for oral rapid HIV testing and other preventive screenings during dental care. Methods. We conducted semistructured interviews between April and October 2010 with a targeted sample of 13 dental insurance company executives and consultants, whose firms' cumulative market share exceeded 50% of US employer-based dental insurance markets. Participants represented viewpoints from a significant share of the dental insurance industry. Results. Some preventive screenings, such as for oral cancer, received widespread insurer support and reimbursement. Others, such as population-based HIV screening, appeared to face many barriers to insurance reimbursement. The principal barriers were minimal employer demand, limited evidence of effectiveness and return on investment specific to dental settings, implementation and organizational constraints, lack of provider training, and perceived lack of patient acceptance. Conclusions. The dental setting is a promising venue for preventive screenings, and addressing barriers to insurance reimbursement for such services is a key challenge for public health policy.

Original languageEnglish (US)
Pages (from-to)881-887
Number of pages7
JournalAmerican journal of public health
Volume104
Issue number5
DOIs
StatePublished - May 2014

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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    Feinstein-Winitzer, R. T., Pollack, H. A., Parish, C. L., Pereyra, M. R., Abel, S. N., & Metsch, L. R. (2014). Insurer views on reimbursement of preventive services in the dental setting: Results from a qualitative study. American journal of public health, 104(5), 881-887. https://doi.org/10.2105/AJPH.2013.301825