Self-Reported Behavior and Attitudes of Enrollees in Capitated and Fee-for-Service Dental Benefit Plans

by Ian D. Coulter, Marvin Marcus, James Freed, Claudia Der-Martirosian, Norma Guzman-Becerra, Barbara Genovese, Dana P. Goldman

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Dental care is not immune to the wave of rising costs that has hit other sectors of the health care industry. In an effort to contain those costs, insurance providers have increasingly turned to capitation plans (CAP), which shift the costs of care to the dentist, rather than fee-for-service plans (FFS), wherein costs are shifted to the patient. How do the two types of plans differ in terms of their effect on patient behavior and perceived level of care? This report gauges how people rate their plans and their oral health through a bivariate and multivariate analysis of the results of a survey submitted by 2,340 respondents — 57.7 percent of them in FFS plans and 42.3 in CAP plans. The authors analyzed several variables, including income, out-of-pocket-costs, and demographic categories, that gave rise to significant differences in perceptions of oral health, satisfaction with plan, and satisfaction with dentist. The authors conclude by noting that a general dissatisfaction exists with CAP plans as compared to FFS plans.

Table of Contents

  • Chapter One

    Background

  • Chapter Two

    Research Design

  • Chapter Three

    Results

  • Chapter Four

    Summary

  • Chapter Five

    Discussion

  • Appendix A

    Premium by Company, Market, and Plan Type

  • Appendix B

    Table B.1: Premium or Premium Range by Company, Plan Type, and Market B: Table B.2: Distribution by Company, Plan Type, and Market

  • Appendix C

    The RAND Patient Interview Schedule

The research described in this report wasperformed under the auspices of RAND Health.

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