Week 2 - CONVERGE 2020

  • Register
    • Non-member - $150
    • Full Voting Member - $100
    • Non-Voting Member - $100

This Week 2 CONVERGE 2020 package includes all recorded sessions from Week 2.

  • NADP Members - $100
  • Non Members - $150

  • The Future of Dentistry Is Now

    Contains 1 Component(s) Recorded On: 10/01/2020

    $200 for NADP Members | $300 for non members

    This presentation discusses three innovative projects in various stages of progression pursued by the College of Dental Medicine, Columbia University. A fourth topic deals with the impact of student debt on the future of dental faculties and the dental profession. Each topic will be followed by a Q&A period. Overall, the presentation will provide insight into the need to align the dental profession with societal pressures, unleashing innovation and entrepreneurship.

    Topics:

    • Shared Medical-Dental Health Records
    • Medical, Mental and Dental Integration – Primary Care
    • Towards Big Data Informing Individualized Dental Education and Practice
    • Student Debt Chokes the Next Generation of Dental Faculties

    Christian Stohler, DMD, DrMedDent

    Dean

    Columbia University College of Dental Medicine

    Christian S. Stohler, DMD, DrMedDent, started his tenure as dean of the Columbia University College of Dental Medicine and senior vice president of Columbia University Irving Medical Center, in 2013. He received his DMD degree from the University of Bern, Switzerland, where he also earned the DrMedDent degree and obtained certificates in oral & maxillofacial surgery and prosthodontics. From 2003-2013, he was the dean of the School of Dentistry, University of Maryland. Before joining the University of Maryland, he held several positions at the University of Michigan, including professor at the School of Dentistry, research scientist at the Center for Human Growth and Development, director of research at the School of Dentistry, and professor and chair of the Department of Biologic and Materials Sciences. While at Michigan, he was named the William R. Mann professor and held the Roy & Natalie Roberts endowed chair. Dr. Stohler received awards and recognitions, including the Schweitzer Research Award, recognition awards from the NDA, Pierre Fauchard Academy, the Orthodontic Education and Research Foundation, the Distinguished Service Award from the University of Michigan, the Horace Wells Merit Award, and an honorary Ph.D. degree from Nippon Dental University. He served on and chaired the Board of Scientific Councilors at the National Institute of Dental and Craniofacial Research. He is a fellow of the American College of Dentistry and the International College of Dentistry.

    Jon Seltenheim (Moderator)

    Executive Coach

    Jon Seltenheim retired in 2017 from United Concordia Dental where he was senior vice president of government and business strategy. Prior to that, Mr. Seltenheim had increasing roles of responsibilities with Cigna Healthcare in claims, customer service and marketing.

    Mr. Seltenheim’s undergraduate degree is from Westminster College and served on the Board of Trustees from 1992-1996. He presently sits on the Eastern University Board of Trustees and is on the Dean’s Advisory Committee of the Columbia University College of Dental Medicine. His M.B.A. is from Miami University of Ohio.

    Jon provided leadership to the National Association of Dental Plans where he served on the board from 2002-2006, as chair from 2004-2006. He led the Healthcare Reform Task Force from 2008-2013 and most recently chaired the search committee for the new Executive Director, for whom he has since been retained as the executive coach. Jon was awarded the Gabryl Award in 2008 and the Don Mayes Leadership Award in 2013.

    Jon recently completed an executive coaching program through American University and has begun a practice serving business and individual clients on career and organizational issues.

  • A Claims-Based Study of Utilization of Dental Services among Adults 65 and Older

    Contains 1 Component(s) Recorded On: 10/01/2020

    $200 for NADP Members | $300 for non members

    Although adults age 65 and older spend more on dental care than other age groups, 70 percent lack dental coverage, and many lose their dental insurance after retirement. Furthermore, Medicare does not cover or reimburse most routine dental services. As a result, high out-of-pocket costs and a lack of price transparency impede timely dental care for older adults: In 2018, over half of adults age 65 and over in the United States reported that they had not visited the dentist in the past year, owing primarily to financial barriers. Without routine preventive dental services (e.g., dental cleanings), older adults can experience poor oral health and, concomitantly, poor general health. Untreated dental issues likewise can lead to increased usage of emergency departments (EDs); over two million individuals visit the ED for dental pain each year.

    Drawing on the nation’s largest repository of private healthcare claims data, this session will present a claims-based analysis of utilization of dental services among adults 65 and older. The analysis will:

    • Examine trends in the utilization of preventive dental services and treatments (e.g., root canals, tooth extractions, scaling and root planing) among adults and compare them to those age 65 and older;
    • Identify trends in ED visits pertaining to dental diagnoses among this population compared to other age cohorts;
    • Explore trends in the dental claims data for older adults by gender and location; and
    • Analyze the rise of teledentistry services by region and gender.

    Additionally, the session will illuminate the decline in dental service utilization during the COVID-19 pandemic in adults age 65 and older, and compare it to the decline in younger age cohorts. Individuals at risk of severe cases of COVID-19 were targeted for emergency dental care only, not preventive care, and those 65 and older were considered at risk.

    FAIR Health looks forward to sharing our recent findings regarding older adults’ utilization of dental services, particularly amid the COVID-19 pandemic.

    Robin Gelburd, JD

    President

    FAIR Health

    Robin Gelburd, JD, is the president of FAIR Health, a national, independent nonprofit organization with the mission of bringing transparency to healthcare costs and insurance reimbursement. FAIR Health possesses the nation’s largest collection of private medical and dental claims data, which includes over 32 billion claim records contributed by payors and administrators who insure or process claims for private insurance plans covering more than 150 million individuals. Certified by the Centers for Medicare & Medicaid Services (CMS) as a national Qualified Entity, FAIR Health also receives data representing the experience of all individuals enrolled in traditional Medicare Parts A, B and D; FAIR Health includes among the private claims data in its database, data on Medicare Advantage enrollees. FAIR Health licenses data and data products to payors, providers, government agencies, researchers and others. The company also uses its database to power a free, award-winning website that enables consumers to estimate and plan for their healthcare expenditures, as well as learn more about healthcare reimbursement. Ms. Gelburd is a nationally recognized expert on healthcare policy, data and transparency.

  • The Three R's of Optimizing Your Network

    Contains 1 Component(s) Recorded On: 09/30/2020

    $200 for NADP Members | $300 for Non Members

    We all have the goal of delivering the most optimal network to our members to meet their needs and our business needs. But with so much disparate provider data from multiple sources needed to paint a clear picture, pulling it all together to make data-driven decisions to optimize your network can be a challenge.

    Join Zelis to discuss the three R's of optimizing your network:

    1. Remove providers who are low quality, high cost or simply do not exist by integrating complex provider elements into your analysis
    2. Replace these providers by identifying network access gaps and bench marking the maximum accessibility possible in a market using state and federal standards.
    3. Recruit high quality, low cost providers to maintain your competitive advantage and understand your competitive position in the marketplace

    There are many factors to optimizing your network. The three R's of network optimization will help you prioritize each step of the process.

    Laura Kravet McMullen

    Director, Client Engagement

    Zelis

    Laura McMullen has significant experience in diverse aspects of the healthcare industry. She has provided marketing and communications expertise at Cigna Dental, National Healing Corporation, and the University of Miami Sylvester Comprehensive Cancer Center. As Director of Client Engagement for Zelis Network Analytics, she draws on her industry knowledge to help customers leverage network analytics to drive business results. Educated at Nova Southeastern University and the University of Florida, Laura currently serves on the Education Commission for the National Association of Dental Plans, keeping her ear to the industry’s trends and needs.

    Jillian Carlile, MBA

    Senior Research Analyst

    Zelis

    Jillian joined Zelis in 2013 and is a member of the product and strategy team at Zelis Network Analytics.

    With a background in the fine arts and a master’s degree in business administration, Jillian’s creative approach to problem solving consistently produces innovative solutions. Her passion for understanding market trends and industry issues helps her identify the opportunities where Zelis’ strengths are well-matched to solving clients’ challenges.

    Jillian delivers actionable insights about provider networks while helping clients stay informed of relevant changes in the marketplace.

  • The Effects of the COVID-19 Shutdowns on Dental and What’s to Expect as the Country Re-Opens

    Contains 1 Component(s) Recorded On: 09/30/2020

    $200 for NADP Members | $300 for Non Members

    The Effects of the COVID-19 Shutdowns on Dental and What’s to Expect as the Country Re-Opens

    Jerry Berggren, MBA

    Director of Research & Information

    National Association of Dental Plans

    Jerry brings more than 20 years of experience in market research, strategy and analysis to his role at NADP.  Prior to joining NADP in 2004, Jerry worked in market research and advertising in healthcare, financial services and electric utility industries.  Jerry earned his BA in Political Science from Louisiana State University and his MBA from Tulane University.

  • Election 2020: Projections, Politics, and Policy

    Contains 1 Component(s) Recorded On: 09/30/2020

    $200 for NADP Members | $300 for Non Members

    How likely is it that the Senate will flip in 2020? Will Democrats keep their majority in the House? What could shifts in partisan control of any branch of government mean for health care policy in 2021 and beyond? Join experts and NADP representatives in DC Lisa Layman and Kelly Delmore for insights on key Senate and Congressional races, the outlook for health care policy moving forward, and implications for the dental benefits industry.

    Lisa Layman

    Principal

    Hooper, Lundy & Bookman

    Ms. Layman has 25 years of experience in political and legislative affairs and a comprehensive knowledge of health policy issues. She represents clients in health care matters before Congress and the Executive Branch on legislative, regulatory and administrative issues. She also provides strategic advice and counsel to clients on broad public policy and program goals as well as specific client business needs.

    Prior to going into private government relations practice, Ms. Layman served as a member of the U.S. Senate Legislative Staff for 11 years. She was a senior policy advisor to U.S. Senator Debbie Stabenow and earlier in her Senate career advised Senators Bob Graham, Richard Bryan and John Chafee on health care matters.

    During that time, she was involved in drafting, analyzing and negotiating legislation involving Medicare, Medicaid, prescription drugs, managed care, health information technology and private health insurance.

    She also worked on health care issues for the Congressional Budget Office, preparing baseline and legislative cost estimates.

    Following her tenure with the US Senate, Ms. Layman held the position of Vice President for Government Affairs at the Generic Pharmaceutical Association (now known as the Association for Accessible Medicines). In that position, she worked closely with generic pharmaceutical executives to develop and execute public policy and lobbying strategies.

    For nine years prior to joining Hooper, Lundy & Bookman, Ms. Layman was a principal in the Government Law & Strategies practice of Brown Rudnick, where she represented the interests of health care clients before Congress and regulatory agencies.

    Kelly Delmore

    Principal

    Hooper, Lundy & Bookman

    With almost two decades of Capitol Hill, association and private sector experience, Ms. Delmore advises clients on political strategy, advocacy and health care policy. She is highly regarded on both sides of the political spectrum. Given her deep health care business knowledge, Ms. Delmore has worked effectively with companies, coalitions and associations to create policy solutions and legislative opportunities.

    She has represented various health care clients before Congress and the executive branch over the years, including; hospitals, dialysis providers, health care provider associations, large regional health systems, national health insurance associations, Medicare Advantage plans, cancer centers, and pharmaceutical companies, amongst others on an array of policy matters.

    Prior to becoming a consultant, Ms. Delmore held the following key roles in DC; Director of Federal Government Affairs for the American Physical Therapy Association, Legislative Assistant to House Ways & Means Committee member Rep. Phil English (R-PA), and Regulatory Policy Analyst for the American Osteopathic Association. Before her time in Washington, DC, Ms. Delmore worked in hospital settings in Pittsburgh, PA, where she focused on health information technology, cancer registry, and HIPAA implementation.

    Ms. Delmore holds a B.S. in Health Information Management and a Master of Health Administration from the University of Pittsburgh.

  • Creative focus on early childhood caries and the role dental plans may play in early intervention

    Contains 1 Component(s) Recorded On: 09/30/2020

    $200 for NADP Members | $300 for non members

    This session will explore using educational and entertaining content to drive more patients into the office in the target age group which includes children under the age of 3. Yonder explains that by introducing the practice to families at home via a virtual pre-visit app experience, dental offices can engage with families at earlier ages. As a result, more cleanings at earlier ages to decrease caries at future visits.

    Adam Choe, MS

    Co-Founder

    Yonder

    Adam Choe, MS, is a Co-Founder of Yonder. Adam was the Managing Director at gener8tor, an early stage venture capital accelerator, with former exp at St. Jude Medical, Nestle Healthcare, & two research fellowships. Adam launched the first healthcare accelerator in Minnesota. Adam has worked with 40+ portfolio companies and those companies have gone on to raise $20M+ in dilutive and nondilutive funds.

  • Dental Consultants: Love Them, Hate Them, How To Work With Them

    Contains 1 Component(s) Recorded On: 09/29/2020

    $200 for NADP Members | $300 for Non Members

    In light of the growth of dental consultants, panel discussion will include two carriers, specifically selected for taking different approaches to working with consultants -- and two dental consultants, who will share why consultants exist and how to work with them effectively. The session will cover the following topics:

    1. Historical background on growth of dental consultants (and reasons behind the growth)
    2. Various approaches that carriers are taking toward dental consultants
    3. How carriers can work with dental consultants to execute their goals

    Chad Hendricks

    CEO

    Clear Choice Consulting

    Chad has worked in the Dental Industry for over 17 years. He spent my first 16 years working at two large DSOs, American Dental Partners (ADPI) and Midwest Dental. Chad spent 13 years at ADPI, heading up their payer relations department for much of that time. He also oversaw ADPI’s revenue cycle and credentialing teams. At Midwest Dental, Chad took a similar path, leading their payer relations team, credentialing and eventually revenue cycle too. Chad was with Midwest Dental for three years before he started Clear Choice Consulting. Clear Choice Consulting was formed to support dental groups both large and small and to support solo offices as well. His primary support focus areas are payer relations, credentialing and revenue cycle. Chad has always been a big advocate of the payer/provider partnership and tries to continue that as a consultant. Chad has been a member of the NADP for over ten years. He is a graduate of the University of Minnesota.

    Chuck Stewart

    Founder

    DDS Consulting

    Chuck Stewart is founder and managing consultant for DDS Consulting, a dental consulting firm. Chuck and his team apply a unique combination of provider and carrier experience to help insurance carriers, dental support organizations (DSO’s), and individual dental practices become best in class.

    Previously, Chuck served as Director, Business Development for Smile Brands, one of the nation’s largest DSO’s. Chuck oversaw Plan Relations, a commercial sales team, and sales for an in-house dental plan.

    Before joining healthcare, Chuck built a career in the product repair industry. He served as Director of Business Development for Sears, Roebuck and Co. Chuck oversaw the sales and marketing of Sears Service and A&E Factory Service brands to Fortune 500 companies. Prior to joining Sears, he held positions of increasing responsibility at Sony Electronics.

    Chuck earned a BSc and MBA from Arizona State University.

    Rita Moravec

    Assistant Director for the Dental PPO Network

    Principal Financial Group

    Rita Moravec is the assistant director for the Dental PPO Network at Principal Life Insurance Company. In the 16 years at Principal, Rita has worked as a dental network recruiter, manager of Large Group/Retention and now in her current role, she leads a team dedicated to the Dental Service Organizations (DSO’s) and retention of the overall network. Rita has been in the dental industry 30+ years, 10 in private practice and 20 on the carrier side. She holds an MSA and an MBA from Central Michigan University. In her spare time, she is involved in a number of community outreach projects.

    Greg Grocholski

    Dental & Vision Vice President of Network Development & Credentialing

    Argus/Aflac

    Greg has 23 years of network development experience including the recruitment for Medicaid, Medicare, Commercial Exchange, DHMO, and Commercial PPO networks nationwide.

    Michelle Hart, RDH, MBA

    Associate VP

    Strategy Advancement

    Michelle has been in the Dental Industry for over 30 years, working in a variety of practice settings as a registered dental hygienist for more than 10 years before expanding her education and experience onto the Payor side and receiving an MBA in Health Care Administration from Bryant College. She served in many different capacities at Delta Dental of Massachusetts including UR/UM and Provider Relations before moving to Guardian for 22 years in Dental Networks and started a new opportunity 2 years ago with Humana. In her current role at Humana as associate vice president, Strategy Advancement, Michelle is responsible for network expansion and retention for all lines of business ensuring that all Humana members have access to participating dental providers in order to maximize their dental benefit.

  • Confronting the Opioid Epidemic with New Oral Health Programs

    Contains 1 Component(s) Recorded On: 09/29/2020

    $200 for NADP Members | $300 for Non Members

    Opioid prescriptions commonly have been associated with wisdom tooth extraction, as this is intensive oral surgery performed on more than 5 million people annually, primarily young people. In fact, oral health professionals write 12% of all opioid prescriptions, including more than 54% of opioid prescriptions for adolescents – an age group especially vulnerable to misuse, addiction and overdose. This presentation will address a comprehensive and strategic approach to oral health to confront the opioid crisis from all angles, to prevent misuse of drugs and addiction, deliver tailored treatment to those who are addicted, and support long-term recovery.

    Successful interventions include pharmacy policy changes, outreach to dental health professionals and consumers, and broad public education efforts. To that end, a new public toolkit provides information for oral health professionals and consumers, including an educational flyer with commonly asked questions related to opioids and a checklist to help people better understand pain-management options before and after wisdom-teeth removal.

    Together, these efforts to date have resulted in an 89% reduction in opioid prescriptions above federal guidelines written by network dental health professionals for UnitedHealthcare dental members age 19 and younger. The speaker will provide details on the steps industry stakeholders, including health plans, care providers and governments, should take to help support the health of young people and address the connection between dental care and opioids.

    Richard Gesker, DMD, MBA

    Chief Dental Officer

    UnitedHealthcare Dental

    Dr. Richard W. Gesker is the chief dental officer of UnitedHealthcare Dental, a national ancillary benefits company serving the oral health needs of more than 11 million people enrolled in commercial and government programs.

    Dr. Gesker leads the development of innovative clinical quality initiatives, clinical strategic direction, and clinical policies, promoting access to quality and cost-effective dental services for enrolled members. He serves as the company’s chief advisor and thought leader on clinical quality and care management related to oral health, including representing the organization with various external alliances such as the American Dental Association, National Association of Dental Plans, and Harvard School of Dental Medicine.

    Prior to joining UnitedHealthcare Dental in 2020, Dr. Gesker spent more than 17 years in a variety of healthcare leadership roles spanning private practice, nonprofits and the military. He previously served as a lieutenant dentist in the United States Navy; chief dental officer for Mary’s Center, a primary care medical center in Washington D.C.; and director of professional development for Dental Associates in Milwaukee. In these roles, he applied his expertise in developing clinical protocols, cultivating health care provider relationships, enhancing the patient experience and supporting multi-office strategic initiatives.

    He holds a Bachelor of Science degree from Drexel University a Doctor of Dental Medicine (D.M.D.) and an M.B.A. from Temple University, where he previously served as an adjunct professor.

  • Mindfulness session sponsored by Aetna (week 2)

    Contains 1 Component(s) Recorded On: 09/29/2020

    Mindfulness session sponsored by Aetna (week 2)

    image
    image
  • Credentialing: Where is it headed?

    Contains 1 Component(s) Recorded On: 09/29/2020

    $200 for NADP Members | $300 for non members

    Credentialing: Where is it headed?

    Mike Cole

    Vice President of Insurance Plan Management

    Dental Care Alliance

    In April 1999, Mike Cole joined Dental Care Alliance (DCA), an NADP Associate member and one of the largest dental service organizations in the country. As vice president of Insurance Plan Management, Mike oversees the teams responsible for insurance relations, revenue cycling and the credentialing departments. Prior to joining DCA, he was a network manager for both Prudential Healthcare and United Concordia. With more than 30 years in the dental healthcare industry, he was instrumental in fostering partnerships between DCA and the insurance plans. Working together to achieve the best outcomes has led to creation of the NADP credentialing application, NADP-supported directory validation process and innovations with the patient experience. My received the Don Mayes Award at CONVERGE 2019.

    Mike has been active in the NADP for the last eight years and has served on the Operations Workgroup, where he is currently the vice chair. Mike is a graduate of the University of Missouri – Columbia and is also a Certified Employee Assistance Professional (CEAP).

    Bret Guenther, CEBS

    CEO

    Dentistat, Inc. & go2dental.com, Inc.

    Bret is the President of Dentistat and President / Founder of go2dental and has overall responsibility for the companies. Bret has over 38 years in the Employee Benefit field, with 25 years in the dental benefits space. Bret’s background includes working for The Travelers Insurance Company and as a Principal at a Brokerage firm.

    Dentistat provides Network Management services and is one of the largest dental Credentialing Verification Organizations. Dentistat has been certified by NCQA 7 times.

    go2dental has been helping consumers gain access to valuable web-based information to help them make better choices concerning their overall oral health care. Go2dental provides dental plans with a customized member experience to improve member satisfaction and improve the client’s value proposition. go2dental has been in business for over 20 years and works with over 25 dental plans.

    Bret earned his Bachelor of Science in Marketing from San Jose State University and his Certified Employee Benefits Specialist (CEBS) degree from The Wharton School of Business in Pennsylvania.

    LeAnn Morris

    Vice President of Business Relations

    DentalXChange

    Le Ann Morris is the vice president of Business Relations for DentalXChange and has been with the company for over 10 years with an additional 20 years of experience working as the western regional sales director for a medical clearinghouse. In her time at DentalXChange, Mrs. Morris has headed the team to launch Humana’s and United HealthCare’s all payer portals, as well as the national launch of Delta Dental Plan Association’s ERA solution. She has also led the team to expand DentalXChange’s web based, credentialing platform, DDS Enroll and recently completed multiple implementations with Delta Dental payer networks, expanding DDS Enroll to seven states; with 4 more plans scheduled for implementation by early 2021. She has been supporting the DSO market for over a decade and sees credentialing as a major need. Mrs. Morris has been extremely active in the dental community, including being the NDEDIC Committee Chair in 2010 and a pivotal leader in Uniting the Industry, where providers and payers joined together to improve electronic delivery of eligibility and to reduce costs to all parties. Organizations are looking for innovative, dental driven tools and for over 30 years, Mrs. Morris has been leading the development and launch of these products.