Tuesday, April 28, 2015

CHIP Passes – But There’s Still More To Be Done

By Steve Pollock, President and Chief Executive Officer
On April 14, Congress passed a bill which will ensure that eight million children across the country have continued access to health insurance by extending funding for the Children’s Health Insurance Program, or CHIP, for two more years. Just a few days later, President Obama signed the bill into law. The CHIP program 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. Without passage of this bill, CHIP funding would have expired in September, leaving millions of children and hundreds of thousands of pregnant women without access to comprehensive dental care.
Since its inception in 1997, CHIP has helped children receive routine dental care that they may not otherwise have had access to. To help illustrate its success, a report issued by the U.S. Department of Health and Human Services found that 80 percent of CHIP enrollees saw a dentist in the past year, a significantly higher rate of access and use of services than for children who do not have coverage.
Congress has done a commendable job of recognizing the need for continued funding to support children’s health insurance by passing bipartisan legislation to secure its future. This is no small feat. Health equity advocates around the country are breathing a sigh of relief knowing that the health and well-being of our children took precedence over party politics. However, for dental care, we know the battle is not yet over.
Did you know that 83 million Americans still face obstacles in receiving dental care each year? Nearly half of all individuals in a 2013 survey said that over the previous 12 months they or a family member delayed seeing a dentist because they could not afford the expected out-of-pocket costs. Unlike medical insurance, states are not mandated to include adult dental care coverage within Medicaid programs; it is left up to the state to decide.
As a result, many still do not have access to dental benefits. And that hurts families. It is difficult for dentists who treat children with Medicaid or CHIP insurance to turn away parents who have immediate oral health problems but are uninsured. Dental care contributes to a person’s health and well-being over their lifespan – childhood through retirement. Preventive care saves families and taxpayers money by avoiding more costly interventions later on.
Without adult dental benefits for publicly-funded insurance programs, these 83 million Americans will continue to flood emergency rooms for dental issues and contribute to the 164 million work hours missed each year due to oral health problems. And, as recent studies demonstrate, poor oral health may be increasing the cost of treating chronic diseases like diabetes, pre-term pregnancy and heart disease. By ensuring that all have equal access to dental care, we work to improve the lives of millions while reducing healthcare costs.
Congress took a significant bipartisan step to ensure access to dental care for children. Now, state and federal leaders must act to help eliminate barriers for adults so these 83 million Americans can get the care they need to be healthy and stay that way.

Wednesday, April 22, 2015

When We Pay for Performance, Prevention is Key

By Steve Pollock, Chief Executive Officer

In the midst of a constantly-evolving climate in health care, one thing is constant: our pursuit of the triple aim. In my last blog post, I discussed how ancillary benefits can achieve the goals of the triple aim: to improve population health, advance quality of care and reduce long-term costs. Here, I’ll discuss another way payers and providers can solve this puzzle -- through pay-for-prevention programs.

Pay-for-performance programs encourage providers to keep their patients healthier through financial incentives. A national survey found that 52 percent of health maintenance organizations (HMOs) have implemented some form of pay-for-performance already. Additionally, the Affordable Care Act includes a number of provisions that encourage this goal of controlling costs while increasing health outcomes. We’re finding that this means we need to do more than reactive care.

Preventive care is the solution across the board, be it medical or dental services. Oral disease is preventable, not inevitable. Treating cavities is much more costly – to the patient, the provider and the payer – than providing the initial services that could have prevented the cavity in the first place.

Working with our health plan partners, DentaQuest has found a way to weave in a pay-for-performance program that has been successful through our PreventistrySM initiative. In one program, we saw an increase in the number of higher-risk children who received fluoride treatments by 30 percent after just 12 months.

As our health care needs change, we are adapting to ensure our members stay healthy and receive the treatment they need – when they need it.  We are looking for opportunities to shift our focus to treating preventable health issues before they emerge, rather than waiting until patients come to providers after issues arise.

Tuesday, April 14, 2015

Tips for Tots: Set Your Kids Up for Healthy Teeth

By Dr. John Luther, Chief Dental Officer, DentaQuest

Whether it’s changing diapers or taking the kids to soccer practice, parents of children of all ages have ample responsibility to keep their children happy and healthy. Even from an early age, this duty includes promoting good oral health to ensure their kids have healthy smiles for a lifetime.

Current research shows that just over half of children between the ages of six and 11, and 28 percent of preschoolers have tooth decay. Some might say, “It’s okay to have cavities as a child – they’ll lose those teeth anyway.” But, in reality, these statistics are a serious issue. Contrary to what many believe, getting cavities is NOT an inevitable part of growing up.  Dental disease (cavities and gum disease) are nearly 100% preventable. Kids who have cavities grow up to be adults with tooth decay, and that can lead to other serious and costly health problems later on.
Luckily for busy parents, here are a few easy, preventive habits that can help your children maintain good oral health:

Head to the dentist when first tooth emerges
Connecting your child to a dental home, or an ongoing relationship with a dental care provider, from the moment the first tooth comes in is essential to long-term oral health. From the first visit onward, make sure to schedule dental check-ups every six months. You’ll learn the dos and don’ts about taking care of your child’s teeth at home. Also, during these initial preventive visits, a dentist can help make sure your child’s teeth and gums are in optimal condition for permanent teeth to come in.

Before teeth, use a washcloth
While you’re waiting for your baby’s teeth to grow in, get prepared by gently cleaning the gums twice a day with a wet washcloth. When the baby teeth do come in, keep up the routine so the teeth stay strong and healthy, and the mouth will be free of cavity-causing bacteria from the start. The lower teeth typically appear after eight months, followed by the upper front teeth at 10 months and molars at 26 months.

Choose healthy snacks
In moderation, fruits are healthy alternatives to other snacks with added sugars – however, not all fruits are the same. While firm fruits like apples and pears can help keep plaque off the teeth, bananas and raisins are chewy, sticky and full of sugar that can stick to your teeth. Granola bars, another deceivingly unhealthy snack, are packed with sugar. So, when you give your child a mid-day snack, think about nuts or seeds instead which help rebuild tooth enamel. If your child is very young, it’s a good idea to check with your pediatrician about peanuts.

Avoid surprisingly sugary drinks
Apple juice and milk are classic childhood drinks, but when provided in excess or at the wrong time, these drinks could promote tooth decay. Watering down juices to a mixture of ¼ juice and ¾ water can drastically cut your child’s sugar intake. If it’s a drink before bed, be sure to stick to water – not milk – as the sugars linger in your child’s mouth overnight, feeding bacteria that cause cavities. After any sugary drinks or snacks, rinse your child’s mouth with water and be sure to brush before bed.