Monday, February 1, 2016

2015 in Review: The State of Dental Care

Looking back on my first year as CEO of DentaQuest, I am in awe of the milestones we have achieved as a nation to advance oral health care and humbled by the crucial role DentaQuest has played in support of the national oral health movement. With a particular focus on expanding access to dental services, goals were met, systems were put in place and new objectives were established.

Oral Health Research Developments

The Early Childhood Caries (ECC) Collaborative, initially launched in 2008 by the DentaQuest Institute, made serious headway this past year as the third phase came to completion.

Phase III testing sites implemented disease management protocol for patients ages 6 to 60, and worked to redesign their care delivery systems to ensure every child receives a caries risk assessment.

To complement this effort, care providers began collaborating with parents to prevent and manage their child’s risk of developing caries. By reinforcing updated treatment protocols and engaging parents to change behaviors, we can positively impact a child’s risk of disease. And, to date, preliminary results have indicated positive outcomes.

Another major DentaQuest Institute development that I blogged about recently is the Medical Oral Expanded Care (MORE Care) initiative

This pilot program equips doctors’ offices with the appropriate tools to provide preventive oral health services in South Carolina, connecting medical and dental practices to establish an integrated referral-based health system. The success of this program lays the foundation for similar programs to adopt this collaborative, holistic approach to a patient’s health.

New Oral Health Goals and Conversation

At the DentaQuest Foundation, the Oral Health 2020 initiative had another successful year. During its annual convening in the fall, the Foundation unveiled new and updated Oral Health 2020 goals, refining an existing goal to raise the number of children who will reach age 5 without a cavity from 75 percent to 85 percent.

Additionally, two new goals were added, aiming to integrate oral health into at least 50 percent of emerging person-centered care models, as well as improving the public perception of the value of oral health to overall health. Transforming the national conversation, the DentaQuest Foundation is constantly looking to break barriers and insert oral health into the overall health and wellness conversation.

Across the country, the Foundation also launched its Grassroots Engagement Strategy, providing grants to support local, community-based organizations. In Arizona, California, Florida, Michigan, Pennsylvania and Virginia, the organizations are working to evaluate, integrate and provide oral health care and knowledge to immensely diverse populations.

The national movement begins at the community level, and we aim to support and enable organizations that align with our mission to advance the oral health of all.

Increased Access to Health Care

In 2015, we reached a major milestone when our vision program, eyeQuest, reached more than 1 million members. Currently in eight markets, eyeQuest offers a full line of vision and eye care services.

On the dental benefits side, we are proud to announce that we are currently serving 24 million members. As we continue to grow, we look forward to providing dental and vision care to many more people seeking high-quality, effective health solutions.

Last February marked the one-year anniversary of DentaQuest managing the Tennessee child dental Medicaid program, TennCare

Helping approximately 750,000 children, TennCare members benefit from lower costs, closer access to services and education on the importance of routine dental care. With the end of our second year quickly approaching, we are excited that we’ll soon be able to share new information about improved outcomes in Tennessee.

Across our organization, we have shared a common goal of creating partnerships to make a lasting impact on peoples’ health. As evidenced by programs such as TennCare, ECC and Oral Health 2020, establishing partnerships can lead to improved outcomes for everyone.

National Advances in Health Care

On April 16, 2015, President Obama officially extended the Children’s Health Insurance Program (CHIP) for two more years. The CHIP extension allocates approximately $20 billion over 10 years to states that help insure children in need.

By the end of 2015, a total of 31 states expanded Medicaid under the Patient Protection and Affordable Care Act (ACA), providing affordable health insurance coverage options to adults through Medicaid in addition to the Health Insurance Exchanges.

In an effort to improve the health system, states and the federal government came to the table in 2015 to advance preventive oral health care. While it will take years to realize all of the benefits of this collaboration, these are very important steps on the path to improve oral heath in our nation.

One great example is the Centers for Medicaid and Medicare Services’ approval of Medi-Cal 2020 – the federal 1115 waiver that allocates funding for crucial health care advancements in California. The Medi-Cal 2020 waiver includes a Dental Transformation Initiative to bring much-needed improvements and changes to the dental care system throughout the state.

What’s Next for 2016

Looking to the year ahead, we must continue with this momentum. Despite the significant progress made last year and the continued focus on the importance of oral health, our work has only just started. 

As an election year, 2016 will certainly be an exciting one with many changes on the horizon. We must work together to build on our successes, foster strong partnerships and grow this oral health movement. Together we can transform the systems of care, finance, policy and community to achieve optimal oral – and overall –  health at the local, regional and national levels.

Tuesday, January 19, 2016

Honoring Martin Luther King, Jr.’s Legacy in Health Care

At DentaQuest, we are motivated by the premise that oral health is a social justice issue, a motivation elevated as we recognize one of the most pivotal figures in American history, Dr. Martin Luther King, Jr.  

It seems like mere words are not enough to appropriately honor Dr. King’s passion and sacrifice in his fight for equality and acceptance for communities of color, and more broadly, for all Americans - simply, his work was nothing short of transformative. 

In one of his most well-known writings, “Letter from Birmingham Jail,” Dr. King wrote:
“We are caught in an inescapable network of mutuality, tied in a single garment of destiny. Whatever affects one directly, affects all indirectly.”

Now, let’s look at just how oral health is a social justice issue. It’s unjust that people in our country live without good oral health, whether the barrier they face is that there are not enough dentists practicing in their area, they cannot get insurance coverage for dental services, the cost of necessary care is just too high, and even worse, if the barrier is based on discrimination of any kind. 

This sentiment that oral health is a right, not a privilege, is reflected in our mission: to improve the oral health of all.

At the DentaQuest Foundation, we’re funding and working with groups across the country to work to improve oral health for all people across the lifespan. This includes directly addressing the disparities we see in the oral health status of communities of color, since data shows that across the country, both children and adults of color experience dental disease at a much higher rate. 

We also know that improving oral health equity for these communities takes commitment from many stakeholders.

Our network partners at the California Pan-Ethnic Health Network (CPEHN) are working to address oral health disparities in their state by empowering communities of color to build a united and powerful voice in health advocacy. 

The foundation supported CPEHN’s recent publication of a brief on promoting equitable oral health policies for communities of color. The brief examines the causes and impact of oral health inequities on communities of color, and provides recommendations to help children and families live healthier lives. The brief addresses:

·         Improved access to and the quality of dental care

o   This means expanded dental benefits for low-income adults, higher reimbursements for dental providers, better integration of oral health into primary care, improved education and outreach on how to use insurance benefits, and improved data collection to identify and analyze oral health inequities by not just race and ethnicity, but also sexual orientation, gender identity, and language. 

·         Developing a culturally competent workforce

o   Programs should be developed to train, recruit, and retain people of color in the oral health fields. Other programs should ensure communities of color can access culturally and linguistically appropriate care. This means that beyond making translation and interpretation services available, providers also give care that bring an understanding and acknowledgement of these communities’ backgrounds, cultures, and beliefs.

In addition to addressing these issues, CPEHN also recommends supporting efforts to improve the other socioeconomic factors that contribute to poor oral health, including ways to promote sustainable career development and improve unhealthy food and environmental conditions.

We’re proud to be partners with CPEHN, and with the many other programs working collectively across the country working to promote just and fair access to oral health, for all. 

Thursday, December 17, 2015

Who Knew? Oral Health and Diabetes

By Dr. James E. Thommes, Vice President, Clinical Management, DentaQuest

On the tails of American Diabetes Month and ahead of the New Year, we want to take a moment to raise awareness about the disease that impacts nearly 30 million children and adults across the United States. And, frankly, diabetes is an even bigger epidemic than that statistic reveals - another 86 million Americans have prediabetes and are at risk for developing type 2 diabetes.

So what’s the connection between diabetes and oral health? 

Many people don’t know that there’s actually a very direct connection between diabetes and oral health. People with diabetes may experience more severe periodontitis, otherwise known as gum disease, because diabetes lowers the body’s ability to resist infection and slows healing.

Additionally, gum disease can make diabetes more difficult to control as blood sugar levels spike throughout the body. People with diabetes can also experience thrush, a mouth infection, among other oral health issues.

The millions of Americans across the country with diabetes already have a lot to manage, but it’s important to also remember dental hygiene, since it’s so directly connected to the disease. Health care providers, advocates and other stakeholders have an important part to play when it comes to raising awareness of diabetes and its connection to oral health, along with helping diabetics manage the disease.

How can we shine the light on the connection between diabetes and oral health?

At DentaQuest, we are helping bridge the gap of understanding, and the gap between dental and overall health. One key way to achieve this is by teaching dentists to uncover possible signs of diabetes during routine dental exams. Dentists can play an important role in spotting undiagnosed diabetes and helping manage the oral health effects of the disease.  

On the other hand, if a physician spots the disease first, he or she can educate the patient about its potential impact on oral health, too, and the important steps the patient should take to maintain oral health.

Another key strategy to spotlight the connection between diabetes and oral health is through consumer education. With a new diagnosis of diabetes occurring every 19 seconds in the U.S., we also must educate consumers and raise awareness beyond American Diabetes Month.

With this in mind, we encourage you to share information about the topic including our free infographic flyer and answers to common questions about the connection between oral health

Wednesday, December 2, 2015

Taking it to the Next Level: Moving from 4 to 6

By Ralph Fuccillo, MA, President, DentaQuest Foundation

In late October, we hosted our third annual Oral Health 2020 National Network Gathering where more than 250 partners from all 50 states came together to assess the state of oral health and to further the growth of the network and collective efforts to improve it. During our time in New Orleans, our grantees and partners were focused on challenges we still face, best practices to move the the needle on oral health, and how to better engage their local communities and enact social change.

We also heard from leaders who challenged us to think even more broadly about the national oral health movement, consider new ways to improve oral health and work collaboratively with all stakeholders. Paul Schmitz, CEO of Leading Inside Out, led an exciting discussion about collective impact and encouraging leadership from unconventional sources. Mr. Schmitz presented an interesting reframing of moments in our history where the emphasis on the actions of one leading individual allowed us to overlook the value of the collective actions by multiple people.

Dr. Camara Jones, Senior Fellow at the Satcher Health Leadership Institute, Morehouse School of Medicine, and President-Elect of the American Public Health Association, shared thoughts and learning on racism and the social determinants of health as critical components of attaining oral health equity.   Her suggestions to promote population health and prevention in the context of health equity were affirmed by the Foundation’s approach to changing systems by including all voices in the conversation. 

Many of our grantees were able to discuss their own challenges and progress with Paul and Dr. Jones, and their keynotes provided stimulating dialogue for the remainder of the event.

From exciting dialogue to crucial problem-solving, there were many important moments at the convening. But, I wanted to highlight one of my favorites. Among our partners, we debuted the updated Oral Health 2020 goals, which now include six goals aimed at eliminating oral health disparities and improving oral health across the lifespan

We raised the stakes by:

  • Upping the target for our first goal: 85% of children will reach age five without a cavity
  • And adding two new goals:
1.       Oral health will be integrated into at least 50% of emerging person-centered care models.
2.       The public perception of oral health will be improved by increasingly including it in health dialogue and public policy.

Across the lifespan and across the nation, we envision a world where oral health is valued as essential to overall health. The Oral Health for All 2020 Network has crafted a strategic roadmap that is comprehensive of all areas that impact oral health. These goals will continue to drive far-reaching impact, engage communities and shape improvements at all levels of health policy, care and access, along with financing methodologies.

The growth to six achievable goals can only happen through a network of leaders who are committed to and focused on the promise of collective impact principles and culture. We are grateful for so many dedicated partners!  

You can learn more about the work of Oral Health 2020, and our grantees and partners by visiting our website, or following us on Twitter, @OralHealth2020.

Monday, November 9, 2015

Integrating Dental and Medical Care: MORE Care, More People

By Steve Pollock, President and Chief Executive Officer, DentaQuest

It’s no secret that millions of Americans lack access to basic oral health care. According to the American Dental Association, 181 million Americans don’t visit a dentist in a given year and nearly half of people over 30 suffer from various forms of gum disease. This is a significant issue plaguing Americans across the country.

And, those who live in rural areas can experience higher rates of poverty, lower oral health education, dental provider shortages and a scarcity of dependable transportation, providing even more barriers to receiving basic dental care. This culmination of factors is creating significant gaps in our oral health care system, leaving many without services they need.

So, what is the solution?

Well, for starters, we need to prioritize medical-dental integration. Under this model, dental and primary care providers alike would take an integrated approach to diagnosis and treatment of patients.

To provide an example, primary care practices would be trained to identify and manage oral health needs for their patients, and also appropriately refer and collaborate with dental partners. Similarly, if a patient went for a routine dental check-up and showed signs or risk of diabetes, the dentist would then refer them to a primary care provider for a closer look.

By training providers in both practice worlds to conduct simple screenings and spot specific signs, we can identify and thus address health issues more quickly. And, in the healthcare system of tomorrow, a connected, efficient network can help identify and address preventable diseases earlier on, while also expanding our reach in underserved communities and improving cost efficiency.

Does medical-dental integration work?

The thinking behind this type of integrated approach is exactly how the MORE Care (Medical Oral Expanded Care) initiative came to life. MORE Care is a pilot program launched by the DentaQuest Institute that connects doctors’ offices with the resources and training to provide preventive oral health services in South Carolina. It also connects medical and dental teams to establish a referral-based system for patients.

Through these efforts, MORE Care has already been able to access rural populations, bringing them reliable, preventive care that previously was difficult to obtain.

Using a phased approach, the DentaQuest Institute, in partnership with the South Carolina Office of Rural Health and Medical University of South Carolina, is initiating pilots of this program throughout the state that build oral health into primary care, while also laying the foundation for dental care referral networks.

In its first year, we’ve worked with six rural primary care practices to collaborate on solutions, test strategies to effectively deliver preventive oral health services, communicate with dental providers and identify best practices for the future of this program.

We’ve also expanded our partnerships (working closely with the South Carolina Dental Association) to enhance the program. 

Will there be MORE Care in the future?

So far, the results are promising – we are reaching underserved patient populations with integrated care and learning lessons to help us improve the program as we look to expand it. We hope to have significant data and insights early next year to inform our efforts to grow our reach.

As all of us in healthcare search for efficient solutions that achieve high-quality results, establishing medical-dental integration programs will allow providers to deliver care to the whole person, reach a patient population in significant need, and ultimately help control healthcare costs. 

Thursday, October 22, 2015

Teledentistry: Bringing Oral Care to You

By Dr. Rob Compton, DDS, President, DentaQuest Institute, and Chief Dental Officer, DentaQuest

Telemedicine, telehealth, teledentistry? Billboards are talking about the first two, advertisements are featuring them, and commercials are promoting them. Virtual health care is here, if only in its early stages. Gone are the days when seeking medical care automatically equated to travel and missed school or work. Providers and patients alike want and now can more easily access necessary, quality care virtually.

But what does an age of virtual health mean for oral health care? That third word: teledentistry.

Untreated tooth decay can lead to other serious and long-lasting complications, including bodily infections and heart disease. This is why teledentistry is such a unique and important opportunity to improve patient care, dentists’ reach, and the oral health of all.

What better way to improve access for underserved communities than to go straight to the person? Through the use of teledentistry, members of the dental team (namely dental hygienists and assistants) are traveling to schools, community centers and nursing homes to perform routine check-ups with virtual oversight from a remote dentist.

School-based oral health screenings, routine check-ups, educational programs, and delivery of preventive care are proven methods for setting kids and adults up for success. An established relationship between a child and a dental care provider leads to:
  • Improved oral health habits
  • A link to the child’s family members, who otherwise may not have access to care
  • Better overall health for both the child and the community at large
But how does this really play out? Let’s take a look at California. California was one of the first states to pioneer an innovative approach to using teledentistry to increase access to care. Designed to reach people in underserved areas around the state, the Virtual Dental Home program offers dental services in community settings like schools and nursing homes.

As part of this demonstration by the Pacific Center for Special Care at the University of the Pacific Arthur A. Dugoni School of Dentistry (Pacific), hygienists and assistants perform routine exams and certain services with supervision by a remote dentist responsible for setting the appropriate treatment plan. Two thirds of those served by the VDH pilots were able to receive all of their care in community settings.

In its first three years, the demonstration program will bring care to 20 communities and benefit nearly 20,000 children and adults across the state.

For every dollar spent on preventive dental services, an estimated $50 is saved on more expensive and complicated procedures, according to California Dental Association President Dr. James Stephens, who spoke about this program during a recent PBS interview.

That cost savings statistic is a great example of what states can achieve when they support preventive care and expand access to dental care. Demonstration programs are already indicating that wider adoption of models like the Virtual Dental Home will continue to break down barriers to access, ultimately resulting in more cost-effective and prevention-focused dental care. The next step for California is to work with the oral health community to encourage wider adoption of the VDH model.

This model for delivering care in the community also allows dentists to fill valuable chair time with patients in need of more comprehensive restorative services at the same time that their dental team is out in the community providing routine preventive care.

We all look forward to a future where everyone has access to all critical services, regardless of where they live. Well, that future begins now. Virtual health care is here, and is ready to bring providers to you. Let’s all work together to make this a reality.

Wednesday, September 30, 2015

50 Years of Medicaid, Yet Oral Health Gaps Remain

By Steve Pollock, President and Chief Executive Officer

In 1965, Medicaid and Medicare were signed into law. At that time, there were more than 194 million people in the United States. Thirty-two million lived in poverty. America’s low-income population was in desperate need of medical coverage and the financial means to access care.

Enacting Medicaid and Medicare was the first step toward helping this largely underserved population. With the intended purpose of providing a public health insurance program for low-income people, Medicaid has made great strides in increasing access to coverage since its inception.

Medicaid Covers More People, Just Not for Dental

From the original 4 million Americans that enrolled in Medicaid to the 65 million who are enrolled today, the goal has remained the same: administer proper medical care to those with limited or scarce resources.

Policy and lawmakers alike have recognized the importance of creating an opportunity for all Americans, socioeconomic status aside, to be protected with quality medical care.

As background, Medicaid provides health coverage to non-elderly low-income parents, their children, other caretaker relatives, pregnant women, and other non-disabled adults. Most recently, Medicaid expanded to include more people under those definitions based on language in the Affordable Care Act.

While Medicaid’s accomplishments to date are something to be deeply proud of, the reality is that there is a major gap that still needs attending to: adult dental coverage.

Medicaid Members Need Dental Coverage

A few months ago, I wrote a blog post on Children’s Health Insurance Program (CHIP) funding being successfully extended for two more years. In that post, I pointed out the decision to include adult dental care coverage within Medicaid is up to each state to decide. As a result of that policy, millions of Americans are left without access to dental benefits. This still holds true, even though oral health is vital to overall health and lower health costs.

In the past decade alone, patients seeking treatment for dental pain in the ER doubled from 1.1 million to 2.1 million. And 80 percent of dental-related ER visits are caused by preventable conditions. This reality means our focus needs to be on providing preventive care that will ultimately cost three times less than ER visits, and save a lot of people from excruciating dental pain.

CHIP is a great example of how mandated dental coverage works. CHIP has been a critical source of health coverage for children and pregnant women who earn too much to qualify for Medicaid but too little to purchase private health insurance. It provides affordable medical and dental coverage to more than 8 million children across the country.

Coverage Leads to Improved Prevention

According to a report from the U.S. Department of Health and Human Services, 80 percent of CHIP enrollees saw a dentist in the past year, a number much higher in comparison to children who do not have coverage. That preventive care will ultimately save kids from future dental emergency visits, keep kids in school instead of at excessive dental appointments, and ensure more kids are pain-free and smiling. 

Moving forward, I urge legislators to rise to the challenge: let’s continue increasing access for those in need and secure adult dental coverage under Medicaid at the federal level.

Oral health is crucial to overall health and wellness, and should be recognized as so by the law. Mandating adult dental coverage is the necessary next step towards achieving improved oral health for all.