Interview: Michael Riccobene, CEO

( ) arranging cover through employers rose 4% to over $21,000 in the year, representing a 55% increase over the last 10 years. On average, workers pay 17% of the premium for single coverage and 27% for family coverage. The average annual deductible for single coverage is now $1,644.

One debate that has raged on in North Carolina for several years (and was amplified by the COVID-19 pandemic) is the expansion of Medicaid. After 900,000 North Carolinians lost their jobs and associated benefits in the months to June 2020, Medicaid enrollment soared by about 75,000. Still, many of those who lost jobs fell within the “coverage gap,” which occurs when someone is earning too much to qualify for Medicaid but too little to apply for ACA subsidies. The pandemic added an estimated 300,000 to the existing 500,000 in this gap, which could be eradicated by the Medicaid expansion. In Durham County, 70,110 are enrolled in Medicaid and in Wake County the number is 180,366. Despite support from the federal government and from Cooper at the state level, the Republican-majority legislature continued to refuse to fund the expansion as recently as June. Adopting the expansion could entitle the state to $1.2 billion over two years in incentives under the federal stimulus bill passed in March. Research by George Washington University also found that expansion would add 37,000 new jobs to the state.

Public health The pandemic also had implications for public health within the Raleigh-Durham healthcare sector. One of the biggest issues to be highlighted amid lockdowns, social distancing orders and job losses was the event’s impact on mental health. Data compiled by the NC Healthcare Association show that 20% of patients discharged from the ER in December were diagnosed with a behavioral health issue, which represents a 7.5% year-over-year increase. There was a much more pronounced increase of 70% among children.

Surprisingly, the state Senate’s budget in June did not include additional funds for mental health despite evidence of a funding gap. But other services are being offered, including Plume, which is a private company that developed an app to provide gender-affirming hormone therapy for the transgender community. There are also various hotlines, including Hope4NC and Hope4Healers.

Prior to the pandemic, the biggest public health issue was the opioid crisis and while it remained at the forefront of public health policy, it too was exacerbated by the pandemic. According to the Kaiser Family Foundation, during the pandemic, about four in 10 U.S. adults reported symptoms of anxiety or depression, making them ( ) Michael Riccobene

CEO Riccobene Associates

How did the pandemic impact your business?

We were very much opposed to limiting our services but when the governor gave the stay-at-home order, and based on how the virus was evolving, on March 27, we adhered to emergency-only services. We needed to make sure that we minimized the spread, which all of us can agree was important. We were at 600-plus employees and reduced that to 135 within two weeks. At the same time, the government handled the pandemic in a good way. They made it easier for businesses like ours to lay people off where we would really have been opposed to it. They were able to provide subsidies to our fired employees that allowed them to stay home for almost the same amount of money that they were making while working. We maintained their benefits and continued to monitor their health, regardless. These measures kept people out of the emergency room and minimized the impact that it would have had on healthcare in general. We started to ramp up as soon as COVID numbers improved and restrictions loosened. It was virtually a V-shaped ramp-up. By June, the pent-up demand from people on lockdown looking to get back out was extraordinary.

What are some of the salient disruptions or innovations driving the dentistry space?

A lot of people have gotten to the point where they want to take better care of themselves. It has really helped in terms of driving people to visit the dentist. Along those lines, dentistry made a technological shift as showcased by SmileDirectClub. The more awareness there is on what they can do, the more patients will come flocking to the dentist. Moreover, we are transitioning from a 2D world to a 3D world. We take digital pictures of everyone’s teeth and show them on a big screen what they actually look like. It builds credibility and it helps people make a decision to do what they need to do. Technology has increased our ability to be able to communicate with people, to build credibility and also help them see the need to get the work done.