1 00:00:00,160 --> 00:00:02,560 Hello. This is Ariana Portolatin with the Becker's 2 00:00:02,560 --> 00:00:05,040 Dental and DSO Ruby podcast. I'm thrilled to 3 00:00:05,040 --> 00:00:07,359 be joined today by Manish Nayak, president of 4 00:00:07,359 --> 00:00:09,599 the dental and vision units at Cigna Healthcare. 5 00:00:09,599 --> 00:00:11,039 Manish, thank you so much for being here 6 00:00:11,039 --> 00:00:12,240 today. It is great to have you on 7 00:00:12,240 --> 00:00:12,900 our podcast. 8 00:00:13,775 --> 00:00:15,154 Thank you very much, Ariana. 9 00:00:15,615 --> 00:00:17,535 Yeah. To start us off, can you introduce 10 00:00:17,535 --> 00:00:19,054 yourself for our listeners and tell us a 11 00:00:19,054 --> 00:00:20,195 little bit about your background? 12 00:00:21,135 --> 00:00:24,095 Sure. So I'm Manish Nayak, president of Cigna 13 00:00:24,095 --> 00:00:27,769 Healthcare's dental and vision business. We serve 17,000,000 14 00:00:27,769 --> 00:00:30,730 customers across the country, mostly in employer sponsored 15 00:00:30,730 --> 00:00:33,149 dental insurance and individual dental insurance. 16 00:00:33,609 --> 00:00:36,590 I oversee everything from network and product strategy 17 00:00:36,729 --> 00:00:37,869 to provider relations, 18 00:00:38,250 --> 00:00:40,189 innovation, and clinical execution. 19 00:00:41,005 --> 00:00:42,784 I joined Cigna in 2011 20 00:00:42,844 --> 00:00:44,844 right after the passage of the Affordable Care 21 00:00:44,844 --> 00:00:47,405 Act to help build and then eventually lead 22 00:00:47,405 --> 00:00:50,284 our individual and family plans business, which eventually 23 00:00:50,284 --> 00:00:52,304 grew to serve over half a million customers. 24 00:00:52,829 --> 00:00:55,810 I then held roles in enterprise operations, including 25 00:00:55,870 --> 00:00:58,990 leading major initiatives following the Cigna Express Scripts 26 00:00:58,990 --> 00:01:02,510 merger and our return to office strategy post 27 00:01:02,510 --> 00:01:03,010 COVID. 28 00:01:03,390 --> 00:01:06,030 Before Cigna, I worked in financial services, helping 29 00:01:06,030 --> 00:01:08,270 launch the home equity lending business at Capital 30 00:01:08,270 --> 00:01:11,045 One and then leading mortgage operations at E*TRADE 31 00:01:11,045 --> 00:01:11,545 Bank. 32 00:01:11,844 --> 00:01:14,004 As far as my educational background, I studied 33 00:01:14,004 --> 00:01:16,644 mechanical engineering at Cornell, and I earned my 34 00:01:16,644 --> 00:01:19,204 MBA from Duke University. I live in Tysons 35 00:01:19,204 --> 00:01:21,465 Corner, Virginia with my wife and two daughters. 36 00:01:21,740 --> 00:01:23,420 My wife is actually a dentist, and I 37 00:01:23,420 --> 00:01:25,420 helped her start her practice over twenty years 38 00:01:25,420 --> 00:01:27,740 ago. So while I'm a little newer working 39 00:01:27,740 --> 00:01:29,579 in this industry, I've been very close to 40 00:01:29,579 --> 00:01:31,100 it for a very long time through my 41 00:01:31,100 --> 00:01:33,659 wife. And what excites me about my role 42 00:01:33,659 --> 00:01:35,180 is the impact that we can have on 43 00:01:35,180 --> 00:01:37,474 whole person health. When we think about our 44 00:01:37,474 --> 00:01:40,034 customers, we're thinking about their vitality, not just 45 00:01:40,034 --> 00:01:42,215 their teeth, and I'm energized by the opportunity 46 00:01:42,354 --> 00:01:44,375 to improve lives through that connection. 47 00:01:45,394 --> 00:01:47,634 Great. Thank you so much for that, introduction 48 00:01:47,634 --> 00:01:49,254 there. It's great to hear about your background. 49 00:01:50,109 --> 00:01:51,629 First question for you here. What are some 50 00:01:51,629 --> 00:01:53,310 of the biggest issues that you're following in 51 00:01:53,310 --> 00:01:54,930 the dental industry right now? 52 00:01:55,790 --> 00:01:57,409 Yeah. I think there's a couple. 53 00:01:57,790 --> 00:01:59,549 You know, I think the first and the 54 00:01:59,549 --> 00:02:01,629 biggest issue in the industry right now is 55 00:02:01,629 --> 00:02:03,694 really the lack of labor. 56 00:02:03,995 --> 00:02:06,655 Dentists are facing an incredible amount of shortage 57 00:02:06,715 --> 00:02:08,974 with specifically hygienist post COVID. 58 00:02:09,835 --> 00:02:11,134 I I see that firsthand, 59 00:02:11,514 --> 00:02:13,354 with my wife's practice as well as my 60 00:02:13,354 --> 00:02:14,495 friends who are dentists. 61 00:02:14,794 --> 00:02:16,074 And I think that's putting a lot of 62 00:02:16,074 --> 00:02:18,314 stress in the system. Dentists are not practicing 63 00:02:18,314 --> 00:02:19,879 at the highest level of their license. 64 00:02:20,259 --> 00:02:22,500 Patients are waiting longer to be able to 65 00:02:22,500 --> 00:02:24,900 get appointments to see their dentist and can 66 00:02:24,900 --> 00:02:27,219 get their cleanings, and that's ultimately leading to 67 00:02:27,219 --> 00:02:28,039 delayed care. 68 00:02:28,819 --> 00:02:31,560 I think second is just the cost pressure 69 00:02:32,180 --> 00:02:32,680 of 70 00:02:33,204 --> 00:02:36,664 employers having now to deal with increasing medical, 71 00:02:36,965 --> 00:02:39,844 pharmacy, behavioral health expenses. And now that we're 72 00:02:39,844 --> 00:02:41,764 seeing that in the dental industry as well 73 00:02:41,764 --> 00:02:44,245 too. So this used to be a very 74 00:02:44,245 --> 00:02:46,840 stable product for employer sponsored health insurance, and 75 00:02:46,840 --> 00:02:49,639 it's changing. It's becoming more dynamic. There's more 76 00:02:49,639 --> 00:02:51,900 pressure on employers to maintain affordability 77 00:02:52,439 --> 00:02:55,000 and that's giving us an opportunity actually to 78 00:02:55,000 --> 00:02:57,799 help shape plan designs and and build our 79 00:02:57,799 --> 00:02:59,479 network in a way that leads to more 80 00:02:59,479 --> 00:03:02,895 affordable products that more people can, leverage. And 81 00:03:02,895 --> 00:03:05,134 I think the third thing, the third sort 82 00:03:05,134 --> 00:03:06,735 of big thing in in dent in the 83 00:03:06,735 --> 00:03:08,675 dental industry is the rise of AI 84 00:03:08,974 --> 00:03:10,115 and, you know, potential 85 00:03:10,814 --> 00:03:11,715 help to 86 00:03:12,254 --> 00:03:15,074 ease the administrative burden that practices are facing. 87 00:03:15,319 --> 00:03:17,000 There's a lot of AI start up. There's 88 00:03:17,000 --> 00:03:19,080 a lot of VC money coming into the 89 00:03:19,080 --> 00:03:21,879 AI space, particularly around oral care. Some of 90 00:03:21,879 --> 00:03:23,800 it is in the clinical space. A lot 91 00:03:23,800 --> 00:03:25,419 of it is in sort of the administrative 92 00:03:25,719 --> 00:03:28,780 overhead space, things like patient eligibility verification, 93 00:03:29,879 --> 00:03:30,939 looking up claims, 94 00:03:31,294 --> 00:03:33,534 and making sure that dentists can actually spend 95 00:03:33,534 --> 00:03:36,414 more of their time actually delivering care than 96 00:03:36,414 --> 00:03:37,715 in managing their practice. 97 00:03:38,334 --> 00:03:40,574 So cost is often the number one reason 98 00:03:40,574 --> 00:03:43,534 patients avoid dental visits. From your experience, what 99 00:03:43,534 --> 00:03:46,194 role can employers and carriers play in reshaping 100 00:03:46,334 --> 00:03:47,539 affordability strategies 101 00:03:47,919 --> 00:03:49,780 to improve preventative care uptake? 102 00:03:50,639 --> 00:03:51,859 Yeah. You know, affordability 103 00:03:52,400 --> 00:03:54,959 is certainly a major barrier to vitality, and 104 00:03:54,959 --> 00:03:57,039 it's one we're working very hard to address, 105 00:03:57,359 --> 00:03:59,519 because oral health isn't just about teeth and 106 00:03:59,519 --> 00:04:02,099 gums. It's deeply connected to overall health, 107 00:04:02,435 --> 00:04:04,995 which obviously in turn affects everything from employee 108 00:04:04,995 --> 00:04:08,034 productivity to long term health care costs. So 109 00:04:08,034 --> 00:04:10,694 when people skip dental care because of cost, 110 00:04:11,314 --> 00:04:13,314 it can lead to more serious and much 111 00:04:13,314 --> 00:04:15,174 more expensive issues down the line. 112 00:04:15,634 --> 00:04:17,574 In fact, sixty percent of Americans 113 00:04:18,310 --> 00:04:20,870 forego dental care due to cost. That's a 114 00:04:20,870 --> 00:04:23,350 staggering number, and it's a clear call to 115 00:04:23,350 --> 00:04:23,850 action. 116 00:04:24,310 --> 00:04:26,550 I think employers and carriers have a real 117 00:04:26,550 --> 00:04:29,990 opportunity here. First, we, Cigna, need to help 118 00:04:29,990 --> 00:04:33,115 employers understand that investing in dental benefits is 119 00:04:33,115 --> 00:04:34,974 an investment in whole person health. 120 00:04:35,435 --> 00:04:38,314 And our role is to create innovative benefit 121 00:04:38,314 --> 00:04:40,954 plan designs which are affordable and easy to 122 00:04:40,954 --> 00:04:41,454 understand 123 00:04:41,995 --> 00:04:44,235 so that more employees actually choose to sign 124 00:04:44,235 --> 00:04:45,375 up for dental coverage. 125 00:04:45,839 --> 00:04:48,240 Then it's about making it easier for employees 126 00:04:48,240 --> 00:04:51,120 to actually use those benefits, whether that's lower 127 00:04:51,120 --> 00:04:53,759 out of pocket costs, smarter plan design, or 128 00:04:53,759 --> 00:04:57,300 incentives that encourage preventive care like regular checkups. 129 00:04:57,920 --> 00:04:58,980 You know, one example 130 00:04:59,644 --> 00:05:02,384 in our partnership with a company called Patient, 131 00:05:02,685 --> 00:05:05,084 which gives our members a flexible way to 132 00:05:05,084 --> 00:05:07,245 pay for out of pocket dental expenses over 133 00:05:07,245 --> 00:05:10,444 time completely interest free. It's a simple no 134 00:05:10,444 --> 00:05:13,084 cost option that helps remove the financial stress 135 00:05:13,084 --> 00:05:15,084 that often keeps people from getting the care 136 00:05:15,084 --> 00:05:15,540 they need. 137 00:05:16,100 --> 00:05:19,540 When we combine smart benefit designed with tools 138 00:05:19,540 --> 00:05:22,020 like this, we're not just improving access, we're 139 00:05:22,020 --> 00:05:24,920 helping people stay healthier and avoiding more costly 140 00:05:24,980 --> 00:05:26,360 interventions later on. 141 00:05:27,300 --> 00:05:27,795 Great. 142 00:05:28,194 --> 00:05:29,735 And how can dental organizations 143 00:05:30,275 --> 00:05:32,915 such as carriers, health care providers, and industry 144 00:05:32,915 --> 00:05:33,415 organizations 145 00:05:33,715 --> 00:05:36,134 play a part in supporting whole person care? 146 00:05:37,154 --> 00:05:39,235 Yeah. That's a great question. You know, whole 147 00:05:39,235 --> 00:05:41,014 person care requires collaboration 148 00:05:41,395 --> 00:05:43,335 across the entire dental ecosystem. 149 00:05:44,079 --> 00:05:47,360 Carriers, providers and industry organizations all have a 150 00:05:47,360 --> 00:05:48,259 role to play. 151 00:05:48,720 --> 00:05:50,579 As an integrated healthcare company, 152 00:05:50,959 --> 00:05:52,899 we focus on leveraging data, 153 00:05:53,279 --> 00:05:56,240 dental and medical data to better understand how 154 00:05:56,240 --> 00:05:58,339 oral health impacts overall well-being. 155 00:05:59,035 --> 00:06:01,615 That integration allows us to use advanced analytics 156 00:06:01,675 --> 00:06:04,394 to identify customers who aren't getting preventive care 157 00:06:04,394 --> 00:06:07,035 and engage them through targeted outreach and marketing 158 00:06:07,035 --> 00:06:07,535 campaigns. 159 00:06:07,915 --> 00:06:10,154 It's not just about offering coverage, it's about 160 00:06:10,154 --> 00:06:12,475 helping people use it in ways that improve 161 00:06:12,475 --> 00:06:13,134 their health. 162 00:06:13,490 --> 00:06:15,569 But health care providers are essential partners in 163 00:06:15,569 --> 00:06:18,209 this effort as well. They're often the first 164 00:06:18,209 --> 00:06:20,449 to detect signs of broader health issues and 165 00:06:20,449 --> 00:06:23,509 their ability to educate patients and coordinate care 166 00:06:23,569 --> 00:06:25,430 is key to driving better outcomes. 167 00:06:26,204 --> 00:06:28,925 I think industry organizations also play a critical 168 00:06:28,925 --> 00:06:30,865 role whether it's through advocacy, 169 00:06:31,404 --> 00:06:32,625 research, education 170 00:06:33,004 --> 00:06:36,284 or setting standards that actually promote integrated care 171 00:06:36,284 --> 00:06:36,784 models. 172 00:06:37,245 --> 00:06:39,745 And finally for employers, incentives matter. 173 00:06:40,349 --> 00:06:42,990 Whether it's rewarding employees for going to preventive 174 00:06:42,990 --> 00:06:46,209 visits or encouraging participation in wellness programs, 175 00:06:46,589 --> 00:06:48,349 we all need to make it easier and 176 00:06:48,349 --> 00:06:50,829 more motivating for people to take action on 177 00:06:50,829 --> 00:06:53,949 their health. We've seen firsthand how integrated care 178 00:06:53,949 --> 00:06:55,169 can drive better outcomes. 179 00:06:55,705 --> 00:06:58,345 For example, our research shows that individuals with 180 00:06:58,345 --> 00:07:01,085 mental health conditions like depression or anxiety 181 00:07:01,625 --> 00:07:04,665 often neglect oral hygiene which leads to more 182 00:07:04,665 --> 00:07:07,545 serious conditions down the line. But when dental, 183 00:07:07,545 --> 00:07:09,725 medical and behavioral healthcare are coordinated, 184 00:07:10,330 --> 00:07:12,330 patients are much more likely to engage in 185 00:07:12,330 --> 00:07:15,069 preventive care and achieve better health outcomes. 186 00:07:15,529 --> 00:07:17,689 It's a really a powerful reminder that when 187 00:07:17,689 --> 00:07:20,270 we treat the whole person, not just isolated 188 00:07:20,330 --> 00:07:22,170 symptoms, we can really make a difference in 189 00:07:22,170 --> 00:07:23,150 their health journey. 190 00:07:24,165 --> 00:07:26,324 Super interesting that, you know, to learn about 191 00:07:26,324 --> 00:07:28,324 integrated care and the tools that insurers are 192 00:07:28,324 --> 00:07:31,125 using to boost integrated care among the dental 193 00:07:31,125 --> 00:07:33,285 community as well. Given that there are gaps 194 00:07:33,285 --> 00:07:35,845 in social detriments of health that create barriers 195 00:07:35,845 --> 00:07:38,084 to oral care, what strategic steps can dental 196 00:07:38,084 --> 00:07:41,610 organizations take to improve access and equity, especially 197 00:07:41,670 --> 00:07:43,529 in rural and underserved communities? 198 00:07:44,470 --> 00:07:46,870 You know, improving access and equity in oral 199 00:07:46,870 --> 00:07:49,509 care, first, I think starts with recognizing the 200 00:07:49,509 --> 00:07:53,290 social determinants of health like geography, income, education, 201 00:07:53,430 --> 00:07:54,009 and language 202 00:07:54,375 --> 00:07:57,254 really do significantly impact whether someone gets the 203 00:07:57,254 --> 00:07:59,574 care they need. Now at Cigna Dental, I 204 00:07:59,574 --> 00:08:01,814 think we take a multi pronged approach to 205 00:08:01,814 --> 00:08:03,355 address some of these barriers. 206 00:08:03,735 --> 00:08:04,235 First, 207 00:08:04,694 --> 00:08:07,735 we're focused on expanding meaningful network access and 208 00:08:07,735 --> 00:08:10,349 this is hard, especially in rural and underserved 209 00:08:10,410 --> 00:08:10,910 areas. 210 00:08:11,449 --> 00:08:13,149 This includes exploring things 211 00:08:13,610 --> 00:08:15,789 like virtual care options like teledentistry, 212 00:08:16,329 --> 00:08:18,729 as well as on-site dental services that bring 213 00:08:18,729 --> 00:08:21,289 care directly to communities where providers might be 214 00:08:21,289 --> 00:08:21,789 scarce. 215 00:08:22,534 --> 00:08:24,694 And we're also looking at benefit design and 216 00:08:24,694 --> 00:08:27,194 making sure the plans reduce cost share barriers 217 00:08:27,254 --> 00:08:30,454 and actively encourage preventive care. I think another 218 00:08:30,454 --> 00:08:32,475 key area is just simply health literacy. 219 00:08:32,934 --> 00:08:35,514 We're reviewing all of our member facing materials 220 00:08:35,575 --> 00:08:37,575 to ensure they're written at a seventh grade 221 00:08:37,575 --> 00:08:40,019 reading level so that they're really easy to 222 00:08:40,019 --> 00:08:42,580 understand and actionable for the widest range of 223 00:08:42,580 --> 00:08:44,040 individuals as possible. 224 00:08:44,500 --> 00:08:46,899 And finally, as I mentioned, we're leveraging data 225 00:08:46,899 --> 00:08:49,860 and analytics to identify populations who aren't engaging 226 00:08:49,860 --> 00:08:52,259 in preventive care. We reach out to them 227 00:08:52,259 --> 00:08:53,399 with targeted campaigns. 228 00:08:53,825 --> 00:08:55,985 Now it's really about meeting people where they 229 00:08:55,985 --> 00:08:58,725 are physically, financially, and educationally 230 00:08:59,504 --> 00:09:02,325 that helps them take steps towards better overall 231 00:09:02,544 --> 00:09:03,044 health. 232 00:09:03,424 --> 00:09:05,264 Yes. Definitely. Thank you so much for sharing 233 00:09:05,264 --> 00:09:07,389 a bit more about there. And I know 234 00:09:07,389 --> 00:09:09,309 technology plays such a huge role in dental 235 00:09:09,309 --> 00:09:12,110 care nowadays, and teledentistry and mobile dental care 236 00:09:12,110 --> 00:09:14,190 have grown so rapidly over the past few 237 00:09:14,190 --> 00:09:17,649 years, of course. How should dental organizations approach 238 00:09:17,710 --> 00:09:20,664 innovation and technology adoption to ensure that these 239 00:09:20,664 --> 00:09:22,924 tools are both effective and inclusive? 240 00:09:24,105 --> 00:09:25,085 Yeah. You know, 241 00:09:25,544 --> 00:09:27,865 post COVID certainly has seen a rise of 242 00:09:27,865 --> 00:09:28,365 teledentistry 243 00:09:28,745 --> 00:09:31,085 adoption, and we fundamentally believe 244 00:09:31,569 --> 00:09:34,289 the teledentistry and mobile dental care have an 245 00:09:34,289 --> 00:09:37,329 important place in the broader ecosystem of delivering 246 00:09:37,329 --> 00:09:39,730 oral health. You know, these tools can be 247 00:09:39,730 --> 00:09:42,629 game changers, especially for people in rural areas, 248 00:09:42,929 --> 00:09:45,250 working parents who can't easily take time off, 249 00:09:45,250 --> 00:09:47,350 or anyone facing logistical barriers 250 00:09:48,154 --> 00:09:49,995 to care. You know, we're focused on making 251 00:09:49,995 --> 00:09:52,495 these solutions both accessible and affordable. 252 00:09:52,954 --> 00:09:56,475 We've had success offering virtual dental consults at 253 00:09:56,475 --> 00:09:58,554 little to no cost, which can help people 254 00:09:58,554 --> 00:09:59,294 avoid unnecessary 255 00:09:59,754 --> 00:10:02,250 ER visits is a major cost saving measure 256 00:10:02,250 --> 00:10:03,629 and a better health outcome. 257 00:10:04,090 --> 00:10:05,789 We certainly recognize teledentistry 258 00:10:06,090 --> 00:10:08,330 isn't ever going to replace in person care 259 00:10:08,330 --> 00:10:10,970 entirely, but it can be a powerful first 260 00:10:10,970 --> 00:10:13,129 line of defense. You know, as as part 261 00:10:13,129 --> 00:10:14,509 of our innovation efforts, 262 00:10:15,014 --> 00:10:17,915 our customers can access a tool called SmartScan 263 00:10:18,295 --> 00:10:20,295 free of charge to get a quick assessment 264 00:10:20,295 --> 00:10:22,774 of their oral health with just a few 265 00:10:22,774 --> 00:10:24,315 pictures from their smartphone. 266 00:10:25,095 --> 00:10:27,620 The intent here is to educate and reduce 267 00:10:27,620 --> 00:10:30,100 the fear and anxiety that many people have 268 00:10:30,100 --> 00:10:32,580 with the uncertainty of seeing a dentist for 269 00:10:32,580 --> 00:10:35,080 the first time or after a long absence. 270 00:10:35,379 --> 00:10:37,700 It gives them something that they can take 271 00:10:37,700 --> 00:10:39,940 to the dental office so that they feel 272 00:10:39,940 --> 00:10:42,565 more confident with what that experience is gonna 273 00:10:42,565 --> 00:10:45,445 be like. And we're also seeing promising results 274 00:10:45,445 --> 00:10:46,425 with mobile dentistry. 275 00:10:46,965 --> 00:10:48,884 Like, it's certainly not a one size fits 276 00:10:48,884 --> 00:10:51,125 all solution. But for the right populations, they 277 00:10:51,125 --> 00:10:52,585 can be incredibly effective. 278 00:10:53,169 --> 00:10:55,410 You know, ultimately, we don't think innovation in 279 00:10:55,410 --> 00:10:57,970 dental care is just about technology. It's really 280 00:10:57,970 --> 00:10:59,970 about meeting people where they are and then 281 00:10:59,970 --> 00:11:01,830 removing barriers to better health. 282 00:11:02,529 --> 00:11:04,450 Some important points that you made there. Thank 283 00:11:04,450 --> 00:11:06,074 you so much for those. Well, that is 284 00:11:06,074 --> 00:11:07,834 all I have for you today, Manish. Thank 285 00:11:07,834 --> 00:11:09,355 you so much for joining us. It's been 286 00:11:09,355 --> 00:11:11,034 a pleasure speaking with you on our podcast 287 00:11:11,034 --> 00:11:12,714 today, and I'm looking forward to connecting with 288 00:11:12,714 --> 00:11:13,774 you again in the future. 289 00:11:14,235 --> 00:11:16,714 Thanks, Arianna. Really appreciate the opportunity to join 290 00:11:16,714 --> 00:11:18,714 you, share a little bit about Cigna Dental. 291 00:11:18,714 --> 00:11:21,048 I listen to this cast frequently, so it's 292 00:11:21,048 --> 00:11:22,648 been fun being a guest. Thank you so 293 00:11:22,648 --> 00:11:24,328 much. Thank you. Enjoy the rest of your 294 00:11:24,328 --> 00:11:24,828 day.