MetLife is continuing to set the standard for value-based dentistry one year into its SpotLite on Oral Health program.
The company launched SpotLite on Oral Health in March 2024, making it one of the first carriers to offer value-based dental care. The program rewards providers for quality of outcomes instead of quantity of care delivered, connecting patients with dental providers who are verified through a proprietary evaluation process.
MetLife Chief Dental Officer Peter Fuentes, DMD, recently spoke with Becker’s to discuss the program’s success over the last year, as well as his thoughts on where value-based care is headed in the dental industry.
Question: What results has MetLife seen a year into its SpotLite on Oral Health program?
Dr. Peter Fuentes: We had two major benchmarking results that we were looking at this year. Number one was, how would providers react to it? Would we get a positive move in the direction? We didn’t change any of our scoring metrics. We left them exactly the same, and I think our first success is we had over a 30% increase in the number of providers who qualified. So we’re up to [more than] 24,000 providers who met the metrics for it this year. We attribute that to a couple of things. Number one, just education and letting providers be aware of the things that MetLife values and some of the things that we look for. Also, it lets us know that we’re also recruiting the right providers because we’re going out and targeting some of the highest quality out-of-network providers. By growing the number of qualified providers, it just opens up that access for more and more members and employees to find these dentists.
The second part is, it’s great we have more dentists, but what are they doing that’s different? What are the outcomes? That’s where I think we’ve had the biggest impact. [There] was about a 17% cost savings from going to a SpotLite provider versus a different in-network provider. Those savings aren’t a direct result of cheaper fees or lower fee schedules, which people would assume. It’s this shift of the majority of their care going to preventive care. Those providers, on average, do 10% more preventive care than non-SpotLite providers. So, it’s driving more cost-effective preventive care, which in the short term is lowering out of pocket costs, but ultimately the bigger savings will be in the long term. As more preventive care is being delivered, the hope is that as this program continues, we’ll actually see a healthier population of our members who are going to these providers.
Q: What was some of the initial feedback from providers when you launched the program, and how has that shifted a year later?
PF: Overwhelmingly positive. Dentists like to be acknowledged for doing quality work. There are not many programs or plans out there that acknowledge and identify providers based on the type of dentistry they do. Most directories are simply just who lives closest to you, whereas our directory prioritizes some of these metrics and quality outcomes, so it also levels the playing field for many of the providers. The feedback I got is, “This is the best advertisement I never had to pay for. It justifies the quality of care that I’m saying I’m doing, and now puts some validation behind it.” It’s the providers who are really putting preventive care front and center [and] are the ones who are being acknowledged, and those are the ones who tend to like to be able to show that to their patient population.
Q: Have there been any challenges with providers shifting to value-based care?
PF: Yeah, I mean, with any new program, there are going to be some growing pains. We understand that. I think just making sure we’re as transparent as we can be and giving the path of, “If I didn’t qualify year one, why not? And what can I do in year two?” Part of it is educating dentists on what quality is in dentistry. Some dentists view quality as, “I can do the most aesthetic filling,” and to some people, that is a quality metric, but the way we look at quality is, are we getting the intended outcomes on the procedures we’re doing? Are we reducing the risk of our patient population? Are we lowering the need for disease treatment because we’re focusing on preventative care to get those outcomes? It’s always about education, and a large majority of dentists understand that, and there were some who sort of needed to understand what the industry’s view on quality is.
Q: What goals does the company have for the program this year?
PF: Just to continue growing. We want to make sure we do a lot of collaboration with our dentists. We have a MetLife advisory board that meets twice a year, and they were integral and helped with designing this program and making sure we’re hearing the feedback [and] being as transparent as we can be to make sure providers understand. Elevating the program, incentivizing these providers even more, is a big key. When we talk about value-based programs, really there are three stakeholders. There’s the member, there’s the employer group and there’s also the provider, and making sure they all have incentives to work together is what’s going to drive success.
Q: How do you see value-based dentistry evolving over the next few years?
PF: I think we’re past the tipping point. I don’t think it’s a niche idea. I think it’s going to be a necessity. I’m proud that we were able to get out in front and sort of set the tone. I think it’s a must. As we’re getting increased cost pressures on everybody, from employees to employers to providers, I think making sure we’re emphasizing outcomes over production is going to be key to a sustainable model in our industry.
