Moda Health has been serving members in Alaska and Oregon with innovative, evidencebased health plans since 1955. Through Moda’s partnership with Delta Dental of Oregon and Alaska, beneficiaries join a national network serving more than 68 million people. Moda prides itself on providing value through high-quality, cost-effective healthcare.

While the healthcare and insurance industries have adopted value-based care metrics that focus on reducing variation in care and improving outcomes, the dental industry has yet to fully embrace the shift towards data-driven insights. As a leader in innovation and service excellence, Moda seized the opportunity to partner with Relias Dentalytics™ to put relevant data in the hands of dentists and leaders. This collaborative approach allowed Moda and their network of providers to identify areas of weakness and target improvement efforts.

Challenge

One of Moda’s largest clients, the Oregon Employers Benefit Board (OEBB) covers over 150,000 beneficiaries in school districts across the state. Although they were pleased with Moda’s service, OEBB valued the increased transparency of value-based care metrics in healthcare. During their contract negotiation, OEBB challenged Moda to provide an innovative technology component to improve oral health outcomes—without increasing prices.

“Moda Health was challenged to provide an innovative technology component to improve oral health outcomes—without increasing prices. As a leader in innovation and service excellence, Moda seized the opportunity to partner with Relias Dentalytics™ to put relevant data in the hands of dentists and leaders.”

Solution

Dr. Barichello, Moda’s Dental Director, created an Oral Wellness Initiative in collaboration with Relias Dentalytics™ and PreViser to pursue innovation and quality from two directions:

  1. Clinical risk assessment (PreViser) to provide customized benefits for at-risk patients at the point of care
  2. Evidence-based analytics (Dentalytics™) to measure and improve key quality performance indicators

Following the agreements, the City of Portland and Adidas learned of the Oral Wellness Initiative and are currently working to develop a similar program with Moda for their populations. Although the trickle-down influence stemmed from the shift to value-based care in healthcare, it is clear employers and insurers want to continue the trend of transparency and improved clinical outcomes in oral wellness.

As Moda sees it, good oral health contributes to good overall health—and that is better for everyone. In addition, Moda plans to help Oregon’s Medicaid population with their Oral Wellness Initiative.