‘A clear alignment between insurers and dentists’
A version of this Q&A first appeared in the Dental Bite Newsletter. Sign up to here to receive the weekly newsletter.
By Carrie Pallardy | for Dental Bite
United Concordia Dental, a subsidiary of Highmark, has more than 10 million members. Edward Shellard, DMD, leads the company as its chairman, CEO and president. He brings three decades of experience to the role, including seven years as a practicing dentist.
Dr. Shellard spoke with Dental Bite about the evolving dental industry, goals for the insurance company and how it is working with dentists to deliver on the shared objective of patient care.
You stepped into the role of president at United Concordia Dental in 2022. How have the challenges and opportunities in the dental industry evolved over the past few years from your perspective?
The past few years have highlighted some significant challenges, particularly around workforce development in the dental industry. The shortage of dental professionals, the growth of dental service organizations (DSOs) and demographic shifts in our population are reshaping how dental care is delivered and accessed. Data from the Health Resources and Services Administration (HRSA) underscores this challenge, identifying over 7,000 dental health professional shortage areas, affecting nearly 60 million people.
Despite these challenges, new companies are entering the dental market with innovative care delivery models, like teledentistry, mobile dentistry and co-location of medical and dental services. These new approaches are giving patients greater choice and pushing the industry to become more patient-centered and responsive to evolving needs. This is driving a competitive and dynamic market, including innovations in benefit models, technology and other areas.
What are some of your primary goals for United Concordia Dental in 2025?
In 2025, United Concordia Dental is building on the significant growth we achieved in 2024, reaching over 10 million members. Our focus is to help more people improve their oral and overall health. A critical part is our emphasis on dental-medical integration with a goal of improving health outcomes for those we serve. This requires dentist, doctor and patient collaboration to promote health changes that provide real results.
Another effort at United Concordia is to continue making it easier for our customers to do business with us. To do this, we’re investing in technology to simplify processes and deliver quick solutions. We work hard to drive value for our customers and ensure our ability to respond to their changing needs.
Data and analytics also play a crucial role in our ability to be responsive. We’re using data-driven insights to help us guide members to the right care at the right time for improved health outcomes. And we’re enhancing our offerings to provide more personalized and comprehensive benefits to better meet their varying needs.
Alongside these efforts, we’re actively strengthening our network of dentists. Recognizing that every dental practice operates differently, we’re dedicated to providing them with the resources and support they need to thrive while making sure our members have access to quality dental care.
How are you and your team navigating the push to transition away from a fee-for-service model and toward a value-based care approach in dentistry?
Our focus is on improving health outcomes and access to care for our members. We see our dentists as key partners in this effort. Through strategic programs that complement existing fee-for-service models, such as recognizing and rewarding dentists who consistently meet clinical and operational performance measures, we are improving the overall experience and total health of our members. We work with dentists to ensure our members get the preventive dental care they need.
The relationship between insurance companies and dentists can be contentious. How do you think both sides can work together to create a more collaborative partnership that focuses on quality care and positive oral health outcomes?
There's a clear alignment between insurers and dentists: both ultimately want to provide members and patients with quality care that leads to positive oral health outcomes.
Data shows that individuals with insurance are more likely to seek care, which is why United Concordia Dental invests in educating members on topics, like the importance of the oral-overall health connection, preventive care and the value of going to the dentist.
But our efforts don’t stop there. We also work closely with dental professionals through programs, initiatives and community partnerships to connect underserved individuals with vital dental care.
The relationship between insurance companies and dentists is mutually beneficial, with a shared focus on the patient’s health and experience. To ensure this, we maintain open and transparent communication with our providers at United Concordia, seeing them as essential partners in our efforts to improve health outcomes. We regularly consult with them to understand their business needs and discuss areas, such as reimbursement, patient volumes and ways we can collaborate to create a seamless experience for both our members and their patients.
Responses have been edited for brevity and clarity.
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