Thursday, February 19, 2015

Get a Head Start: Prioritizing Our Kids’ Dental Care

By Ralph Fuccillo, MA, President, DentaQuest Foundation

As Dr. Luther mentioned in his post last week, February is National Children's Dental Health Month. I’d like to highlight an oral health program for children that is seeing some exciting results, which could serve as a leading best practice when it comes to prioritizing our kids’ oral health. In this collaboration between Massachusetts and Pennsylvania, called Building Successful Collaborative State Oral Health Consortiums, we are addressing oral health disparities and promoting access to care for children.

Most infants and one year-olds in the U.S. have seen a physician, but a mere 2 percent have ever visited a dentist. Surprising to many, children who wait until age two or three to see a dentist actually experience more dental issues than those who visit a dentist on their first birthday, or when the first tooth comes in, as recommended by the American Dental Association. In an effort to change this trend, the DentaQuest Foundation and Head Start Association worked together to encourage early childhood oral health care.

Head Start offers a comprehensive preschool program to low-income children, and also provides families with relevant health information and ensures that children in the program receive regular physical and oral health check-ups.

Through a grant from the DentaQuest Foundation, the Massachusetts and Pennsylvania Head Start Associations created a three-pronged approach to encourage early childhood care for oral health, which includes:
  • Developing relationships with key stakeholders including state oral health and public health organizations;
  • Promoting oral health education; and
  • Increasing access to oral care. 

Now in the third and final year of our initiative, our Head Start partners have experienced promising successes to share in both states.

The Pennsylvania Head Start Association has done a great job of getting the word out about early childhood care. They developed effective oral health coalitions through multiple forums, which had more than 175 participants. Additionally, they've trained more than 250 individuals in the “Cavity Free Kids” curriculum, which helps children practice good oral health habits. Of these trained individuals, many are teachers, infant/toddler specialists, family advocates and more. Furthermore, to date, more than 335 Pennsylvania dentists have been educated on the importance of treating one year-old children.


The Massachusetts Head Start efforts successfully connected children to dentists, giving them a “dental home”. At the start of the initiative, only 19 percent of dentists said they treated children age one or younger. Massachusetts Head Start implemented a program called “Connect the Dots”, to help dentists and primary care doctors understand the importance of starting a dental home at an early age. At the end of the first two years of the initiative, the number of dentists in Massachusetts reporting the treatment of children at age one grew from 19 percent to almost 40 percent.


We're proud of our work with the Massachusetts and Pennsylvania Head Start Associations, but we still have more work to do if we want to meet our national goal of 75 percent of children to reach age five cavity-free. From a national perspective, Head Start programs offer a great opportunity to reach our youngest children at a critical time in their development. We are looking at the lessons learned from the work done in Massachusetts and Pennsylvania, and sharing these tactics with our community partners across the U.S. By training the next generation on best practices, we are mobilizing communities to be sure all children receive the dental care they need, when they need it.

For more information on Head Start, visit http://www.nhsa.org/ (National Head Start Association) and https://eclkc.ohs.acf.hhs.gov/hslc (the Office of Head Start’s Early Childhood Learning and Knowledge Center). 

Friday, February 13, 2015

It’s National Children’s Dental Health Month and Here are Six Steps to a Lifetime of Healthy Smiles

By: Dr. John Luther, Chief Dental Officer and Senior Vice President, Dental Management, DentaQuest

February is not just for Valentine’s Day and cold winter weather - it’s also National Children’s Dental Health Month!

While we often focus on the importance of kids’ oral health in our work (and on this blog) we wanted to take a moment to recognize the importance of this month, and of promoting steps that can help protect the next generation of teeth.

The need for better education and care is clear:
  • In the United States, 28% of preschoolers and 51% of 6-11 year olds have cavities.
  • American children lose 52 million school hours due to oral health problems each year.
  • Dental disease is the most common chronic disease in children in the U.S.- even more common than asthma. 

From the Peach State Health Plan, our partner in Georgia, here are some simple steps that will help you set your kids up to have a lifetime of healthy teeth:

  1. Go see the dentist! There is a misconception that you don’t need to worry about healthy habits until permanent teeth are in. In reality, it begins well before that – cavity-causing bacteria can impact a lifetime of dental health, beginning with the first baby tooth. It’s important to see a dentist at least twice a year, even when those teeth just begin to grow in.

  1. Got fluoride? Believe it or not, fluoride is a crucial part of having healthy teeth - every $1 invested in fluoride saves $38 in treating tooth decay. It’s vital to not only have fluoride in your water, but to also use toothpase with fluoride. Many families are always on the go, so if you give your kids a lot of bottled water, make sure it has fluoride included.

  1. Ask your kids’ dentist about sealants. Dentists can apply sealants to permanent molars when a child is 5-6 years old – before tooth decay even begins - providing a thin layer of protective plastic coating to teeth.

  1. Snack smart. Many snacks kids love – from cookies to potato chips – are high in sugar and starch, which weaken tooth enamel. While its best to limit snacking between meals, be sure to reach for a healthy snack like yogurt, fruit or veggies.

  1. Take two! Everyone should brush their teeth twice a day for two minutes each time. Since two minutes can be an eternity for kids, play their favorite tune while you help them brush their teeth.

  1. Break the thumb-sucking habit. While most kids outgrow thumb sucking, dental problems can occur when kids start to get their permanent teeth and still suck their thumbs. Ask your pediatrician or dentist about ways to help break the habit.

We hope that these steps will help you promote oral health with your kids during this special month and beyond!


And we’d like to say thank you to our partners in Georgia for these excellent pointers. To learn more about the Peach State Health Plan, and some of the innovative work the team there is doing with Emory University, visit: http://www.pshpgeorgia.com/

Tuesday, January 20, 2015

Using Ancillary Benefits to Battle Margin Compression

In a recent post, we examined some of the key drivers of margin compression in this new era of health care reform:

  • Increased taxes
  • Minimum loss ratio
  • Increased competition
  • Greater price transparency
  • Standard benefit requirements

These factors, combined with the substantial costs associated with member churn, are driving a business truism within the health care industry: to effectively battle margin compression, health plans must strive to be present in multiple markets, and they should consider how ancillary benefits can be used to maintain and grow their business.

Of course, our industry is not the first to face game-changing legislation similar to the ACA. Following the attacks of September 11, 2001, airlines grappled both with stricter regulations that were costly to implement and shrinking demand as travelers responded to the tragedy.

Around the same time, websites like Expedia and Orbitz emerged as one of the primary sources to purchase airline tickets. These sites facilitated greater price comparison and increased price transparency, much like we are seeing today within the health care marketplace.  Clearly, this kind of comparative shopping can significantly impact consumer behavior and choice.

The airlines that most successfully navigated these challenges attracted consumers with competitive base pricing and used optional amenity costs - such as added leg room, luggage fees, and food upcharges- to bring in additional revenue. Following a similar model, health plans can use ancillary benefits that appeal to consumers who are interested in purchasing supplemental care, thus preserving a significant portion of their customer base and the associated revenue stream.

Expanding into multiple markets to offset the effects of member churn can be similarly powerful in the fight against margin compression. Offloading members is costly and the movement of members between Medicaid and health exchanges can threaten the overall stability of a health plan by compromising its ability to predict its financial risk. Health plans that have a presence in multiple markets can preempt the negative impact of member churn and better preserve and protect their bottom line.

As is often the case with landmark legislation that impacts such a fundamental part of our daily lives, the Affordable Care Act has brought vast improvements and interesting challenges to the healthcare industry. Health plans have a unique opportunity during this watershed time to explore how ancillary benefits and market expansion can grow and protect their business and membership base.  

Learn more. DentaQuest is hosting a webinar discussing how health plans can use ancillary benefits like dental to grow their market share and control medical costs. Please join me, along with Dr. John Luther, DentaQuest's Chief Dental Officer, and Dr. Justin Cramer, Chief Medical Officer of Missouri Care, who will speak about Missouri's first-hand experience with medical integration.

On the Frontlines of Medical-Dental Integration
Wednesday, January 28
1:30 p.m. CT

Register at www.dentaquest.com/medical-dental-integration/webinar.

Friday, January 9, 2015

Join our Webinar: “On the Frontlines of Medical -Dental Integration”


By Steve Pollock, Chief Operating Officer, DentaQuest

There is increasing evidence demonstrating the relationship between oral and overall health, yet many in the industry don’t realize that in addition to improved health for members, medical and dental collaboration also allows for better care management and thus reduced costs. 

On Wednesday, January 28, 2015 at 1:30 PM CT, I am hosting a webinar to discuss how health plans can use ancillary benefits like dental to grow their market share and control medical costs. I will be joined by Dr. John Luther, Chief Dental Officer for DentaQuest, who will speak about the scientific evidence to illustrate the centrality of good dental health to overall health and Dr. Justin Cramer, Chief Medical Officer at MissouriCare, who will speak about MissouriCare’s first-hand experience with medical dental integration.

The webinar will explore the unique opportunities that exist for health plans seeking to grow their market share by integrating dental benefits into health plan offerings and the healthcare insurance industry’s changing market dynamics.   Through this first-hand account of the challenges and benefits of medical dental integration, attendees will learn strategies to successfully implement the concept.

I encourage you to join us to gain more insight into what I consider to be one of the most important areas of growth for our industry. You can also learn about the benefits of medical dental integration by following this blog series on Oral Health Matters, “Why This Matters to Me.”


Please click the following link to register at no charge: www.dentaquest.com/medical-dental-integration/webinar.

Tuesday, December 23, 2014

A New Year’s Resolution to Smile About



As 2014 comes to an end and we start making our New Year’s resolutions, once again getting healthy seems to be at the top of everyone’s list. But being healthy isn’t just about working out and eating a nutritious diet; good oral health is imperative to one’s overall health.

The New Year is the perfect time to start practicing good oral habits that will last a lifetime. Prevention helps you maintain a healthy mouth, and the single most important thing that you can do to protect your teeth is to brush for two minutes, twice a day, every day. And don’t forget to floss too. It’s equally as important to add this to your child’s daily routine..

Here are some brushing tips for all ages:

Infants, 3 months to 1 year and children, 1 year to 2 years: Gently wipe the baby’s teeth with a clean damp washcloth. For kids under age 2, use a soft toothbrush and a little water with a very small dabble of fluoridated toothpaste. Once teeth are cleaned at bedtime, they should drink only plain water.

Children, 2 years to 6 years: Help your children brush their teeth; hold the toothbrush with them and guide them. Demonstrate how to clean every tooth surface and to gently brush their tongue to remove germs and freshen breath. Use a pea-sized dab of fluoride toothpaste and teach your child to spit out the toothpaste when they’re done. Today there are numerous fun apps that you can download that will make brushing their teeth fun! Check out this video to for more tips on teaching children how to brush their teeth.

Tweens and pre-tweens, 6 years to thirteen: Once your child knows how to brush, let them do so on their own with your supervision. The goal is to spend 2 minutes to ensure they brush every tooth evenly– the front, back, top, and sides. Teach your children how to floss between teeth and instill this as part of their morning and nighttime routine.

Teens and Adults: We are all busy with work, school, sports, and family. However research is showing that poor oral health can exacerbate chronic health problems that people might have once thought were unrelated – such as diabetes and heart disease. Maintaining good oral health can aid in the management of these diseases. Teens and adults should clean they teeth gently but thoroughly for a full 2 minutes before they head out for the day. Finish the day by brushing to remove any leftover food in your mouth and floss between your teeth.

And remember this: Simple, repetitive tasks will become habit in just 21 days. Start on January 1 and make it your goal to brush your teeth for 2 minutes, twice a day, every day. You will have fulfilled one of your resolutions before the second month of 2015! You can do this!

Finally, think about when you last saw an oral health professional. If you haven’t done so in the last six to 12 months, now is a good time to schedule your next visit!


Friday, December 12, 2014

Friday Dental Download: December 12, 2014


This week we discuss why some believe the Affordable Care Act isn’t doing enough for dental plans, learn what South Carolina is doing to improve the oral health of all its citizens, and discover that good healthcare for kids depends on where you live. Don’t forget to check out our new blog series, Why it Matters to Me. Join the conversation on Twitter using #FridayDentalDL.

1. Shortchanged in ACA, dentists hope exchanges can boost coverage: The Affordable Care Act impacts health care providers of all types, but dentists were largely disappointed by its shortcomings in expanding dental coverage. While the ACA deemed dental benefits "essential," requiring insurers to offer dental plans to children up to age 18, the law did not mandate that those plans be purchased, and insurers don't have to offer the same plans for adults. But on the positive side, Dr. Anthony Giamberardino, president of the Massachusetts Dental Society, believes state and federal health care exchanges, the marketplaces where consumers can shop for health and dental insurance, have made people more aware of available dental plans, which could prompt more people to buy coverage.

2. Dental gap: Coverage slips through reform's cracks: Dental care is a peculiar niche of the U.S. healthcare system. Even though teeth and gums are just as much part of the human body as kidneys or elbows, they are insured differently—a lot differently. The question becomes how much the law has done to advance dental care. Not enough, some advocates argue. The Affordable Care Act mandated pediatric dental services as one of the 10 essential health benefits for health plans, but adult dental services were excluded.

3. SC's Healthy Connections program supports oral health: South Carolina's new Medicaid adult dental program emphasizes prevention. That's important because dental problems -- cavities and gum disease – are largely preventable if caught early. We salute the state of South Carolina for the bold steps it has taken to ensure eligible adults have the opportunity for good oral health.

4. How Good Is Healthcare for Kids? Depends on Your ZIP Code: The Department of Health and Human Services has allowed states to choose from a menu of benchmark plans, instead of establishing a federal gold standard for children's health (a decision that runs contrary to the recommendations from the Institute of Medicine). For example, a child with autism or a stuttering problem might fare better or worse depending on where he or she lives. The only way to remedy these problems is for HHS to revise the current essential benefits plan and bar treatment limits and exclusions for children, especially those related to disability or other developmental health conditions.


5. What your teeth are trying to tell you: Statistics show periodontal disease affects over 85 percent of the population. But there's more to your mouth than tooth decay and gum disease. There are some secrets your teeth could be trying to tell you.

Wednesday, December 10, 2014

TennCare Anniversary Highlights Program’s First Year Successes



DentaQuest is marking the one year anniversary of our management of Tennessee’s Medicaid Dental Program, TennCare. We are very pleased to announce that during this first year, we reached or exceeded all benchmarks required by the state of Tennessee.

Our goal with the TennCare dental program was to make it easy for members to visit the dentist and keep their smiles healthy. The importance of establishing good oral health early in life often goes overlooked despite the fact that it is a foundation for lifelong overall health and wellness.

Upon winning the TennCare contract, our first task was to create and manage a dental program that satisfied the needs of members, the state and dentists. We are honored to have the opportunity to work with TennCare Dental Director Dr. James Gillcrist and the dedicated staff of Tennessee’s Medicaid Dental Program in delivering a program that has increased member participation, while significantly reducing program costs. Most importantly, we’re making sure members receive the right care at the right time and in the right amount.

Since October 1, 2014, DentaQuest worked to develop a high-value network from the ground up with a focus on access, quality and efficiency.
  • The current network of 869 dentists ensures that 750,000 Tennessee children eligible for dental benefits receive the highest possible quality of care. 
  • Today, there is 1 dentist for every 857 members. This ratio exceeds Centers for Medicare and Medicaid Services recommended ratio of 1 provider for every 1,500 patients.
  • Members are located 3.4 miles from the closest DentaQuest dentist.
  • The trending dental screening percentage is 90% – surpassing the requirement of 80%.

11 days, 21 hours and 10 hours – That’s the amount of time, on average between the scheduling of an appointment and a member being seen by a provider for routine, urgent care and emergency appointments, respectively.
  • Routine appointments are being scheduled within 11 days. [The benchmark is 21-days]
  • Urgent care appointments are scheduled within 21-hours. [The benchmark is 48 hours]
  • Emergency care appointments are scheduled within 10-hours. [The benchmark is 24 hours]


We are very proud to note that in every instance, we surpassed the required benchmark.

DentaQuest is dedicated to remaining transparent and accountable in our oversight of the program and has released a Report for the Community including findings from TennCare’s November 2014 analysis of the network. Please visit http://www.dentaquest.com/tn/ to download a digital version of the full report.