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.

Thursday, September 17, 2015

Back to School: Advancing Oral Health in the Classroom

By Ralph Fuccillo, MA, President, DentaQuest Foundation

It’s that time of year again – the time when kids all across our country head back to school for another year of learning, growth and development. But, did you know that the classroom is also a crucial point of connection, education and even treatment when it comes to oral health?

If you are a parent, you can attest that you always have your child’s health and wellbeing on your mind, particularly in an age where fast food, lack of exercise and other issues plague the next generation. For kids, tooth decay is actually the most common childhood disease, more common than asthma. Each year, children across the United States lose approximately 52 million school hours due to dental disease. Unfortunately, this impacts low-income children disproportionately, as they face more barriers to getting much-needed, preventive dental care. It’s sometimes a challenge to find a provider that accepts their insurance, and if they are able to secure an appointment, they may have trouble getting transportation to and from the office, and their parents may not be able to take the time off from work to get them there. To drive this home, kids from low-income families have twice the untreated tooth decay compared to their higher-income counterparts.

Schools are a practical and cost-effective place and time to reach children, teach them about healthy habits and even ensure they receive the preventive oral care they need. In addition to education on healthy personal dental care, school-based oral health programs can provide a range of services from screenings to sealants to fluoride treatments. To illustrate the potential of these programs, according to a recent issue brief from the Centers for Medicaid and Medicare Services’ (CMS) Oral Health Initiative, the Centers for Disease Control and Prevention (CDC) estimated that over half of kids’ tooth decay could be prevented if half of those high-risk children participated in school sealant programs.

Think of the potential! This is why one of our Oral Health 2020 goals is centered on this important, cost-effective initiative. By 2020, we strive to have oral health education and services incorporated into the curriculum and offerings of the 10 largest school districts in the country.

To make this goal a reality, we partnered with Oral Health Colorado to develop a toolkit for local communities. The recently-launched, free Smart Mouths Smart Kids (SMSK) toolkit is available to help communities assess need for such a program in their local schools, measure feasibility of program administration and create a program that is sustainable for years to come. Its development took into account best practices and key learnings from our work to provide local stakeholders with the tools they need to make oral health a priority in local schools.

From engaging appropriate partners to understanding reimbursement methodology and building a sustainable business plan, this toolkit has everything a community needs to get started with implementing school-based oral health care – along with support at every step of the way – to help bring dental care and education to the next generation. While the toolkit is focused on Colorado communities, it’s a model that can be scaled and tailored to states across the country.  We encourage you to take a look and share with school administrators, local government leaders, and teachers, and empower your community to bring good oral health back to school this fall. 

Tuesday, September 8, 2015

Missions of Mercy: Oral Health Improvement in Motion

Guest post by Marcia Brand, Ph.D., senior advisor for national policy and programs, DentaQuest Foundation, and executive director, National Interprofessional Initiative on Oral Health

Are you familiar with Missions of Mercy?

Missions of Mercy – sometimes also called “MOMs” – provide dental services, including cleanings, fillings, oral surgery, x-rays and dentures, to people in underserved communities across the country. These services are provided free of charge by dentists and hygienists who donate their time as volunteers. By bringing free dental screenings and care to those who need it most, these missions are a crucial, hands-on way to improve the oral health of all.

I recently volunteered as a dental assistant at the Wise County Mission of Mercy in Virginia. Pat Finnerty, another senior advisor to the DentaQuest Foundation, volunteered as well, managing patient flow in the triage tent.

Southwest Virginia is an area where much of the population doesn’t have access to regular dental care and services. Would you believe that more than 47 percent of the total population of Virginia doesn’t have dental insurance? I hope this helps drive home the importance of these events.

We don't often realize the powerful impact that poor oral health has on the lives of those who cannot access oral health care. I recall one young woman, perhaps 30, who came through the triage tent at the Wise MOM. After examining her mouth, the dentist gently told her that her best option was going to be to have all of her top teeth in the front extracted. There were multiple infections and they could not be saved. He had to step awayand she began to weep. I asked her if she was afraid and she said, "No, they really do hurt me, but I can't get them pulled. I'm a bartender. If I lose my front teeth, I'll lose my job." What a terrible choice she had to make remain in pain, with multiple infectionsor lose her job. Fortunately, we were able to make arrangements for her to have her teeth extracted and get a partial denturebefore her next shift. Stories like these continue to indicate to me that we must improve access to affordable dental care for all.

The DentaQuest Foundation has participated in the Wise MOM project for 11 years. Since its start in 2000, this particular MOM has brought $15.3 million in free dental care to 19,060 patients – what an incredible impact.

This year, we partnered with the Virginia Dental Association, Virginia Commonwealth University School of Dentistry and Dental Hygiene, the Health Wagon, Remote Area Medical, Virginia Health Care Foundation and other sponsors to fund the Wise County event. Over the three days, more than 1,000 patients passed through the triage tent, resulting in a total of 1,181 exams, 177 cleanings, 1,082 x-rays, 1,569 fillings and 3,527 extractions.

For many people, MOM events are the only time all year that they are able to get care. With 69 localities throughout Virginia lacking a dental safety net provider, the MOM events are a critical stop gap that reach more than 4,000 residents annually. 

While MOMs and other similar events provide dental services to people in desperate need of oral care, they also highlight the demand for an increase in access to quality, affordable care. That is why it is the DentaQuest Foundation’s goal, by 2020, to address this unacceptable gap head on. As a part of the Oral Health 2020 goals, we hope to have at least 30 states with a comprehensive Medicaid adult dental benefit and a comprehensive adult dental benefit under Medicare. Will you join us and put oral health improvement in motion?