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Eye on the Industry Market Analysis

Commercial Dental Market Impact Analysis Through Q2 2020

Overview

Throughout the COVID-19 Crisis, P&R Dental Strategies®, and our DentalMarketIQ® (DMIQ) division, will be marshaling our entire arsenal of dental data and analytical firepower, and deep dental domain expertise, to help all dental market stakeholders better understand what’s happening, what to consider, and to answer specific questions we’ve been asked by our clients and colleagues in the market. We plan to produce and share other Coronavirus Impact Insights analyses as the situation develops.

P&R and DMIQ’s data-driven insights are derived from our various data resources, including DentaBase®, our ever-expanding proprietary multi-payer database, which contains over 3.5 billion dental procedure records from 66 national and regional commercial dental insurance payers. DentaBase contains statistically significant utilization, financial and claim review data on over 190,000 US dentists covering 70+ million commercial insurance members and enables us to provide keen, actionable insights that are not available from other sources.

This analysis contains research insights from the latest release of DentalMarketWatch®, our quarterly report that provides historical trends and projected market changes in utilization and fees based on patient utilization and treatment patterns in the commercially insured market and for defined procedure categories.

The Q2 2020 edition of our DentalMarketWatch Report includes a comparison of the 2020 commercial treatment projections we made prior to the COVID-19 crisis and new, COVID-19-adjusted commercial treatment projections assuming only urgent/emergency (non-elective/essential) treatments from late March 2020 through the end of Q2 2020.

Initial guidance from the American Dental Association recommending practices limit dental treatments to only essential (non-elective) treatments was issued on March 16, 2020. On April 3, 2020, this guidance was extended through at least April 30. Subsequent infection control guidance for the Centers for Disease Control and Prevention (CDC) and state level executive orders and regulatory guidance have additional impact. The impact of the COVID-19 crisis continues to evolve daily and impact varies by region. The “worst case” scenario in this analysis assumes that only essential (non-elective) treatments will be performed through the end of Q2 2020.

Recent analyses performed by DMIQ concluded that 17.7% of the procedures in 2019 were highly likely/probably non-elective. 80.7% of non-elective procedures in 2019 were performed by a General Practitioner (GP), with much smaller percentages performed by other specialties. Non-elective procedure percentages varied in 2019 by state, ranging from a low of 9.7% to a high of 22.7%. Public programs are not included in our review and may have higher percentages of non-elective procedures.

On April 18, the ADA issued a modification to their interim guidance to aid dentists who may be reopening their practices when state mandates are lifted. P&R and DMIQ will continue to monitor closely.


Question: What is the projected impact of the COVID-19 crisis on commercial dental treatments from late March 2020 through the end of Q2 2020?

Key Insights – Adjusted COVID-19 Projections*


*Based on historical and projected utilization trends observed in DentaBase®

Commercial Dental Market Overview


Overall Commercial Dental Market

Over 260 million people are estimated to have dental insurance benefits through commercial (private) and public programs across the US. Prior to COVID-19, more than 170 Million people were covered through commercial dental insurance plans.


Estimated Treated Patients

In 2019, the estimated commercial dental treated patients receiving at least one dental service totaled more than 145 million patients (ranging from 145.6 M to 165.3 M). Charges for dental services per patient averaged $1,037 for the same 12 month period – totaling more than $150 billion overall.



Total Treated Patients


Total Treated Patients by Quarter

COVID-19 Adjusted Projections


In Q2 2020, utilization is expected to change materially. During Q2, utilization is expected to be limited to urgent/emergency (essential) treatments only through Q2. DMIQ estimates that 21M to 24M (12% to 13%) of the commercial dental insurance members will receive dental treatments in Q2 2020 – approximately 25% of the Pre-COVID-19 Q2 2020 estimated patient volume.


Total Treated Patients by Quarter

Pre-COVID-19 Projections



Total Treated Patients


Quarterly Treatments

COVID-19 Adjusted Projections


In Q2 2020, utilization is expected to change materially. Utilization is expected to be limited to non-elective (essential) treatments only. DMIQ estimates 53M to 60M total dental treatments for commercial dental insurance members in Q2 2020 – 17.7% of the Pre-COVID-19 Q2 2020 estimated treatment volume.

As of this report date, >22M individuals are believed to have filed for unemployment benefits as a result of the COVID-19 crisis (which will likely affect the total number of commercial dental insurance members in the coming weeks).


Quarterly Treatments

Pre-COVID-19 Projections



Quarterly Submitted Charges


Quarterly Treatments

COVID-19 Adjusted Projections


In Q2 2020, DMIQ estimates $4.7B to $5.4B in dental service charges for commercial dental insurance members – <10% of the Pre-COVID-19 Q2 2020 estimated treatment charges ($). The Pre-COVID-19 projections expected $48.7B to $55.2B in dental services charges during Q2 2020.


Quarterly Submitted Charges

Pre-COVID-19 Projections



Overall - Rolling 12-month Totals


Quarterly Treatments

The projected decreases in Q2 total treatments and submitted charges per patient results in an overall projected reduction of >$40B ($43.9B to $49.8B) in treatment charges

COVID-19 Adjusted Projections



Overall - Rolling 12-month Totals

Pre-COVID-19 projections estimated the same total treatments per patient YOY and a 2.4% increase in submitted charges YOY.

Pre-COVID-19 Projections




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