Manager of Research & Analytics CareQuest Institute for Oral Health
Participants should be aware of the following financial/non-financial relationships: . Madhuli Thakkar-Samtani, BDS, MPH: I do not have any relevant financial / non-financial relationships with any proprietary interests.. Lisa J. Heaton, PhD: I do not have any relevant financial / non-financial relationships with any proprietary interests.. Abigail Kelly, MS: I do not have any relevant financial / non-financial relationships with any proprietary interests.. Eric Tranby, PhD: CareQuest Institute for Oral Health (Employee). Julie Frantsve-Hawley, PhD, CAE: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Abstract: Objective: Periodontal disease and diabetes mellitus have a suggested bidirectional relationship based on systemic inflammation. The aim of this study was to examine the relationship between periodontal treatment and cost of diabetic care in both Medicaid and commercial claims data.
Methods: This study included overall outpatient, inpatient, and drug costs in 2019 for patients diagnosed with diabetes mellitus between 2013-2019 from the IBM Watson MarketScan Medicaid and commercial databases. Using dental claims data and Current Dental Terminology (CDT) codes, we identified whether individuals received periodontal treatment in 2017 or 2018. Generalized linear modeling with a gamma error distribution and a log-link function was used to examine the association between overall healthcare costs per patient by utilization of periodontal therapy services. An average treatment effect on treated (ATET) was calculated by propensity score matching using a logistic model for periodontal therapy on covariates.
Results: In the Medicaid data, enrollees with diabetes who had a periodontal treatment in 2017-18 showed a 16% decrease in average overall healthcare costs compared to individuals with diabetes without periodontal treatment during the same period ($14,795 versus $17,181; ATET=-2917.84 (SE=223.29); p<0.001). Similarly, in the commercial claims database, periodontal treatment reduced overall healthcare costs by 13% compared to no periodontal therapy ($13,915 versus $15,739; ATET=-2498.20 (SE=285.21); p<0.001).
Conclusions: Receiving periodontal therapy reduced overall healthcare costs for patients with diabetes in both Medicaid and commercial claims data. Expanding Medicaid and Medicare coverage to include comprehensive periodontal treatment has the potential to reduce overall healthcare costs for individuals with diabetes.
