1. State of the Dental Market: Outlook 2018
Marko Vujicic, PhD
Chief Economist & Vice President
Health Policy Institute

2. The ADA Health Policy Institute

3. The ADA Health Policy Institute

4. Today

5. Today

6. Today

7. The Economy
Economic growth continues, with gains among the middle class.

8. The Dental Economy

9. The Dental Economy

10. The Dental Economy

11. The Dental Economy
Medicaid just became the top payer for emergency room visits for dental conditions.

12. The Dental Economy

13. Dental Care Utilization

14. Dental Care Utilization

15. Dental Care Utilization
Medicaid expansion under the Affordable Care Act increased dental care use among low-income adults by 3 to 6 percentage points.

16. Dental Benefits Coverage

17. Dental Benefits Coverage - Children

18. Dental Benefits Coverage - Adults

19. Dental Benefits Coverage

20. Dental Benefits Coverage
Medicaid expansion led to 5.4 million low-income adults gaining dental coverage.

21. Cost Barriers to Dental Care

22. Cost Barriers to Dental Care

23. Cost Barriers to Dental Care

24. Cost Barriers to Dental Care

25. Cost Barriers to Dental Care

26. Cost Barriers to Dental Care

27. A ‘New Normal’ for Young(ish) Adults?

28. A Growing Market for Kids and Seniors?

29. Untreated Caries

30. Key Take-Aways
Dental spending rose slightly in 2015 after years of stagnation. Driven mainly by increases in Medicaid and CHIP spending.
Dental care use is rising steadily among (lower-income) children and (higher-income) seniors. Dental care use is flat among adults overall, but up slightly among lower-income adults due to ACA.
Cost barriers to dental care are falling for all age groups except 65+. Driven partly by increases in dental coverage rates among all age groups, both public and private coverage.
Substantial reduction in untreated caries among children in last decade, especially vulnerable populations. Disparities are narrowing. No significant changes for adults or seniors in untreated caries rates or disparity levels.
Data suggest a ‘New Normal’ for young(ish) adults. Recent increases in dental coverage rates and reductions in cost barriers to dental care have not translated into increased dental care use. Dental care use continues to rise steadily for (lower-income) children and (higher-income) seniors.

31. Supply of Dentists
More dentists…more young dentists…more women dentists…

32. Supply of Dentists

33. Dentist Workforce Profile

34. Dentist Workforce Profile

35. Dentist Workforce Profile

36. Dentist Workforce Profile

37. Dentist Workforce Profile
39% in 2016

38. Dentist Workforce Profile
Medicaid reimbursement to dentists is in line, nationally, with reimbursement to physicians. But a much smaller share of dentists participate in Medicaid.

39. Dentist Workforce Profile

40. Dentists Earnings

41. Dentist Busyness

42. Dentist Busyness

43. Dentist Fees (Submitted Charges)

44. Dentist Fees (Submitted Charges)

45. Payment Rates (Paid Amounts)

46. Payment Rates (Paid Amounts)

47. Key Take-Aways Supply of dentists continues to grow.
Dentist workforce is getting younger with a higher share female. Racial and ethnic diversity varies widely by state but in aggregate, White and Asian over-represented and Black and Hispanic under-represented.
Practice ownership rates are declining among all age groups. Share of dentists in DSOs increased in Medicaid and CHIP participation increased slightly in 2016.
Dentist earnings increased in 2016 after several years of stagnation. Busyness has been increasing slowly and steadily since 2012.
Dentist fees (charges) have increased in most states in the past 5 years after adjusting for inflation. However, dentist reimbursement (paid amount) has declined in the vast majority of states.

48. Looking Ahead to 2018… Uncertainty around Affordable Care Act
Continued pressure for employers to manage premium costs. Coverage rates are rising, but are benefit levels?
Continuation of dental care use trends.
Continuation of supply-side trends.

49. “Skate to where the puck is going to be, not where it is.”
Opportunities…
Explore partnerships with different patient “touch points”.
Tackle the convenience problem. The patient is in charge now.
Get ready for the “value agenda” to hit dentistry.
“Skate to where the puck is going to be, not where it is.”

50. @ADAHPI ADA.org/HPI hpi@ada.org
Thank You!
@ADAHPI ADA.org/HPI