VBP 2024

Only 52 percent of Delta Dental Healthy Kids Dental (HKD) members in Michigan have seen a dentist. At Delta Dental, we believe this number can and must increase.

Through value-based payments Delta Dental hopes to grow utilization and reward providers for participating in HKD. For 2024, Delta Dental will focus on the incentive program below:

For ALL Delta Dental Healthy Kids Dental participating providers, if Delta Dental HKD utilization in the state

reaches 53 percent, your practice is eligible to receive a 5 percent performance incentive on:

• Oral evaluations - codes D0120, D0150, D0145
• Sealants - code D1351
• Fluoride - codes D1206, D1208

Incentive program details: As you can see from the example below, the incentives can add up. By providing these services, you have the opportunity to earn a larger incentive, while increasing utilization of a critical program for oral health.

To view utilization for your practice and proactively reach out to Delta Dental Healthy Kids Dental members that were seen in your office, visit Dental Office Toolkit® and click on "metrics scorecard" while logged in.

A current list of your Delta Dental Healthy Kids Dental members who are eligible for services can be viewed by clicking on the most recent month. To assist, we will be text messaging members and parents/guardians of the importance of dental care.

Thank you for being part of our Delta Dental Healthy Michigan Plan provider network and for seeing UPHP HMP and adult Medicaid members. You truly are smile champions!

As you may know, many HMP and adult Medicaid members are now eligible for services that weren't previously covered, and we would like to thank you for providing those services with a bonus incentive.

UPHP and Delta Dental are implementing a Value-Based Payment program this year. From 1/1/2024-12/31/2024 you will earn a four percent bonus for every service you provide for UPHP HMP and adult Medicaid members. This bonus is in addition to what you are currently receiving as reimbursement. Thank you for your participation in our network and for providing services for our UPHP Healthy Michigan and adult Medicaid participants.

Beyond the four percent bonus, which is guaranteed for all services provided, Delta Dental and UPHP are offering an additional bonus tied to performance. If the overall number of UPHP HMP and adult Medicaid members receiving dental services and the number of dental services delivered during each appointment increases, you will receive an additional one percent bonus on all paid claims.

Delta Dental will track performance throughout the year, providing quarterly updates on this page. The bonus incentive will be paid to your practice in April/May 2025 to allow time for claims to be received and processed, as well as to calculate performance.

Eligibility for this program is contingent on you operating in accordance with all applicable Delta Dental policies, state or federal regulations, and industry standards of care. Failure to abide by any applicable Delta Dental policies, state or federal regulations, or industry standards of care may result in exclusion from this program. Delta Dental may, at any time and at its sole discretion, revise and/or terminate this program.

If you have any questions, please contact your Delta Dental professional services representative.

Michigan children in foster care are required to have a dental visit within 90 days of placement and once per year for those already in foster care. With your help, we can make that happen!

Delta Dental of Michigan offers you a $50 bonus per child in foster care per visit when you provide services from October 1, 2023, to September 30, 2024, with up to three appointments per foster child. This program and incentive are only available to providers in northern Michigan and the Upper Peninsula.

*Final incentive is calculated based on paid claims for eligible foster care members treated between 10/1/2023 and 9/30/2024 in your practice. All eligible claims must be received by 12/31/2024 to be included in the final calculation. Any incentive payments earned will be issued by the end of March 2025.

Only providers in these counties are eligible for this incentive: Alcona, Alger, Alpena, Antrim, Baraga, Benzie, Charlevoix, Cheboygan, Chippewa, Crawford, Delta, Dickinson, Emmet, Gogebic, Grand Traverse, Houghton, Iosco, Iron, Kalkaska, Keweenaw, Leelanau, Luce, Mackinac, Manistee, Marquette, Menominee, Missaukee, Montmorency, Ogemaw, Ontonagon, Oscoda, Otsego, Presque Isle, Roscommon, Schoolcraft, and Wexford.