Closing 2017 - Ringing in 2018!

This December, we post some closing thoughts from people across the organization - together, we share pride and gratitude for the strides we as a company have made to benefit communities nationwide. Let 2018 bring greater progress toward a future where everyone has access to oral health, without exception.

I’ve never been more excited about the future of our enterprise. With strategic change and the work of the entire team we are able to drive both social and economic value to help us meet our mission-  to improve the oral health of all. -- Steve Pollock, President & CEO

It is a great time to be part of DentaQuest – our future does look bright! -- John C.

Educating and serving the communities we live… feels great to be part of the Team! -- Fatima

I am very thankful to have a wonderful Boss and Leadership team overall. I am thankful for my family and friends. I am thankful for my continued good health.May you all be safe during this Holiday Season. -- Diana S.

Great job to everyone in this organization that works so hard to ensure we offer the best customer experience possible. A special shout out to the customer service team that is on the front lines with our members and providers every day. - Angela K.

Looking very forward to 2018 and continuing to grow and evolve our organization!! -- Bill P.

Looking forward to an exciting New Year in 2018 with DentaQuest and our new (and existing) Leaders!! Happy Holidays Everyone!!! -- Susan H.


Look for a new blog location in 2018! Oral Health Matters, which remains a key part of our ongoing oral health conversation, is moving ... stay tuned and stay safe. From all of us at DentaQuest

A Quality Improvement Director Goes to the Forum...

This week, staff from DentaQuest’s Institute attended the 2017 Institute for Healthcare Improvement (IHI) Forum. During this multi-day conference, healthcare professionals from around the globe meet in Orlando to talk healthcare improvement. While oral healthcare is not a prominent discussion topic, DentaQuest has been attending since 2011. 

At Monday's pre-conference Scientific Symposium, Dr. Natalia Chalmers and Quality Improvement Project Manager Carrie Peltier presented a poster on our Dental Caries Management (DCM) Collaborative results (pictured left). Over 200 posters were submitted for consideration; the Institute’s poster was one of 70 - and the only one on oral health - chosen. Dr. Chalmers commented that the buzz about the importance of good oral health being vital to overall health was inspiring. Many wanted to learn more about the DentaQuest approach.

The general session featured a series of keynotes and 200+ workshops topics covering improvement science, joy in work, leadership, population health, person-centered care, safety, moving from volume to value to name a few. 

This year’s Forum opened from the lens of patient experience. The keynotes challenged care teams to create a bidirectional transfer of knowledge between patient and care team; this is, in fact, an act of caring. Care teams must work to create this space. It truly matters. Keynote Tiffany Christensen commented: we must ask generous questions to know and learn what matters to our patients. Our job is to make sure there is equity. These sentiments very much resonate with the Institute.

Later in the afternoon, we heard from Bryan Stevenson, a social justice advocate. Mr. Stevenson powerfully reminded us that it is our duty to create healthier communities. We must get closer to the poor and to communities that have been marginalized, neglected, and isolated. There is power in proximity. We also need to change the narrative that defines the difference of race. We must stay hopeful, as our hope has to fuel our practice. And lastly, we need to do the things that are uncomfortable. We have to make the choice to do the difficult thing.

General Stanley McChrystal shared his Team of Teams vision. He spoke about organizational change; being at an inflexion point and ready. He talked about ‘shared consciousness,’ meaning to connect on something with purpose and time and focus. “Together we need to project 'this place' where we want to go and make it to fruition.” This requires leadership that composes self-awareness, discipline, decision making, effective communication, connection, constant learning and functional excellence.

Lastly, as is IHI tradition, we heard from Dr. Don Berwick, president emeritus and senior fellow at IHI. Dr. Berwick’s spot-on remarks and reflections on the American healthcare system ring true year after year, and this year was no different. He shared a moving personal story of needing - and using - the healthcare system for his own family. He charged organizations to “snuggle,” meaning outline a clear and common purpose, be all together, or none at all and provide a safe vessel – failures are instructive; it’s OK to try, there can be shared honor, and we must have affection and mutuality. As this culture is what saved his brother.

Healthcare is complex; like the organizations who provide care and coverage. Inter-organizational competition is not the answer; coordination is. And DentaQuest is no different. Leaving this year’s Forum, I couldn’t help but board my plane back to Boston with some puffed feathers … DentaQuest has these pieces. We are prime to be the ‘Leading Voice.’ Improvement work is a social thing. It asks us to reflect, to adjust, to learn from, and to collaborate. It demands that we ask is what we are doing better or more of the same? We want better; we want to improve the oral health for all. That means understanding the system, at the macro, meso and micro levels. All together, or none at all. We must always ask “what do we want to learn over time?” and chart that course.

Cheers to another amazing Forum. Kaiser Permanente sent over 400 staff this year. Won’t you consider joining us next December in Orlando? This stuff matters!

----

Cindy Hannon, MSW

Quality Improvement Director 

DentaQuest Institute  

"When you believe in this stuff, it is easy to write!"

Reaffirming our commitment to oral health in rural America

As rural stakeholders from around the country take time today to celebrate Nov. 16th as National Rural Health Day, DentaQuest reaffirms its commitment to improving the oral health of residents living in rural communities. DentaQuest Institute and DentaQuest Foundation have been involved in multiple activities and initiatives in recent years that help to improve oral health access and quality of oral health care for our nation’s rural residents. 

A few of the highlights include:

• The Institute’s Medical Oral Expanded Care (MORE Care) Initiative, which focuses on the integration of oral health care into the rural primary care practice as well as the development of coordinated care networks with community dental providers, has assisted more than 20 rural primary care practices and dental providers in South Carolina, Pennsylvania, and Colorado. Based on learnings from the MORE Care initiatives in the three states, several publications were created to spread resources and knowledge to other rural communities interested in creating rural interprofessional oral health networks.
• White Paper -  “MORE Care: Narrowing the Rural Interprofessional Oral Health Gap” https://www.dentaquestinstitute.org/rural-ipp

• Rural Practice Guide – Released today – that provides practice-level guidance and practical how-to tips for rural health clinics interested in creating interprofessional oral health networks in their community: http://bit.ly/2AQ0LmR 
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• The Foundation’s support of the National Rural Health Association has enabled community health workers and other providers in Texas to be trained to integrate oral health into their outreach to residents living in colonias, Hispanic-populated communities along the U.S.-Mexico border.

• DentaQuest Foundation grantee National Conference of State Legislatures is educating policymakers on issues that challenge rural communities in their access to oral health care, developing and publishing resources that can be found on their website, here.

• Lastly, we’ve been proud to see some of our rural oral health leaders featured in The Journal of Rural Health and also NRHA’s Compendium of Rural Oral Health Best Practices.

For more information on these and other great projects being led by our Institute and Foundation teams, please visit the websites at www.dentaquestinstitute.org and www.dentaquestfoundation.org. You can also sign up for Socious, our Foundation’s online collaborative platform, to access resources and tools generated by our grantees and partners. Register here: www.oralhealth.network

Oral Health 2020 is helping unify and empower community voices

Hear from so many passionate individuals who are part of the DentaQuest Foundation's Oral Health 2020 National Network, which is working to address oral health equity, policy, and ultimately improved oral health for all.

Learn more about the movement: http://dentaquestfoundation.org/oh2020

Q&A: Dental Hygienist Opens Up for National Dental Hygiene Month

As October comes to an end, so does the national observance recognizing the need and importance of dental hygiene. For this Q&A, one of our own registered dental hygienists (RDHs) opens up about how she came to this career path and why it is invaluable to the oral health care system.

Let's dig in with Laura Skaret, RDH, BSDH | Project Manager, Safety Net Solutions | DentaQuest Institute

Q: Why did you decide to become an RDH?

A: My mom is a dental hygienist, and I got my first job at her office as a dental receptionist and then later was trained on the job to work as a dental assistant. I loved my experience as an assistant and found the work we did fascinating – including the devastating results of dental disease. I saw the cycle of dental disease first hand:  teeth would need small restorations, then larger restorations, then root canals, then crowns, and even sometimes implants. I knew I wanted to focus my career on helping patients prevent and properly manage dental disease rather than repairing the damage after it occurs.

We had a pamphlet in the office that said that enamel was far more valuable than gold (referring to a gold crown).  I found that to be such a thought-provoking and accurate concept.  It’s also similar to the old familiar adage, “an ounce of prevention is worth a pound of cure.”  That couldn’t be more true in the dental field.

Q: Why are hygienists important in the care team? 

A: Dental hygienists are patient advocates. When explaining the dental disease process to patients, I always tell them that my job is essentially to keep them out of the dentist’s chair, but I can only do so much without their buy-in.  Due to the nature of plaque biofilm, the daily care that patients do for their own mouths is far more important than the work that we do in one hour with them at the dental office. Patients go to the dental office maybe two to four times per year, however 365 days a year they are responsible for managing their own oral health.  This means our most important role is to educate and motivate our patients to improve their daily oral health habits. 

Q: What has been your greatest accomplishment or most proud moment in relation to working as an RDH?

A: I’ve realized that it’s not only what you do, but the way that you do it that can make an impact.  I always try to be very kind and compassionate to the questions and concerns of my patients. I’ve had several patients who were terrified of coming to the dental office when I first met them. Years of neglecting their mouths and avoiding the dentist would bring them to our office in a lot of pain and in need of quite a bit of dental work. In addition to using a gentle technique and local and topical anesthetics, I try to help them feel more comfortable by talking them through everything I’m doing or telling them stories to get their mind off of the situation. Sometimes it’s helpful to listen to their story to find out why they have a fear, affirm their past concern, and then assure them that won’t happen today. 

When those patients then continue to come in regularly, you know you’ve not only made a difference for their oral cavity, but for their life as well.  I had one patient who needed lengthy measures to address advanced decay and periodontal (gum) disease.  After we completed her first three visits of needed periodontal therapy, she actually sent a card to my office to thank me for helping her overcome her fear of the dentist.  With a more manageable level of fear, she was able to get the care she needed to restore her smile, which gave her back her confidence.

Q: How does your professional background impact/influence/help you in your DentaQuest Institute (DQI) role?

A: My primary role at DQI is as a project manager for Safety Net Solutions (SNS), a DentaQuest Institute program. Safety Net Solutions helps safety net dental clinics adopt targeted business management best practices.  Our focus is to ensure that these dental offices can maintain financial viability to stay open and provide access to care for the underserved. We also help ensure that they understand their capacity and can maximize access to care by optimizing their productivity.  

My previous experience of working in all areas of the dental office (receptionist, chairside with the dentist, and then also as a hygienist) means I have very comprehensive knowledge of how dental offices work, from scheduling appointments, to managing supplies and inventory, to managing the patient’s care experience, to dealing with dental equipment and instrument shortages. Basically, I can understand and relate to almost any concerns our SNS clients have.

Q: Why do you continue private practice once a week? 

A: Although you can technically keep your annual dental hygiene license “active” by simply paying the license fee each year, I want to keep it active with actual patient care, as well. Also I continue to practice because I love the work!  I love working with patients and helping them improve their oral health. I also believe this helps me stay relevant and engaged with my SNS clients and their common concerns. 

Q: What is one message you hope to impart to anyone interested in becoming an RDH?

A: Hygienists are super important members of the care team! As policy changes and we move forward with accountable care organizations and pay for performance insurance reimbursement models, I think the role dental hygienists play in preventing and managing disease will be brought even more into the forefront. When finances are attached to healthy patient outcomes, dental care teams will attach an even higher value to dental hygienists. 

Also, there is a massive shortage of dental professionals – and dentists in particular – nationwide. Maximizing the use of preventive modalities such as sealants, fluoride varnish, and silver diamine fluoride will help address access gaps where dentists are hard to come by, like rural areas.  Of course, we will never stop needing the education and skills of a dentist, but if we can reduce the demand for the skills of a dentist by reducing the dental disease burden, we can help minimize the gap in access to oral health care.  

Interested in learning more about prevention-focused dental care? Check out the DentaQuest Institute's Online Learning Center and let us know what you think! 

Lunch Box oral health education program expands to kids with vision impairment

You may know that our mission is to improve the oral health of all, and starting with young children and health literacy is a great step forward.

Before this school year started, we supported efforts by The Children's Oral Health Institute to grow their national Lessons In A Lunch Box: Healthy Teeth Essentials & Facts About Snacks® program. This expansion enables the program to reach children who have impaired or loss of vision. Everyone needs to care for their mouths in order to have healthy futures, and Lunch Box is ensuring all kids have this chance.

In February, special lunchboxes - now with braille - will be delivered to participating schools along with a volunteer presentation to run the program.

So what is this educational program about healthy teeth and why does it matter? 

The Children's Oral Health Institute, a nonprofit based in Maryland, outlines it clearly:

• Lessons In A Lunch Box: Healthy Teeth Essentials & Facts About Snacks is an educational oral health literacy program developed around a lunch box designed exclusively to teach elementary school children. The lunch box includes a color coordinated carrot case with a rinse cup top designed to store a toothbrush, toothpaste, and dental floss.
• The program is created to help children to begin learning early, throughout grade school, about taking care of their teeth, making good diet choices and careers in dentistry.
• The Children’s Oral Health Institute believes the program and the exclusive lesson guides, including the Code Red: The Oral Health Crisis In Your Classroom booklet, will encourage teachers to incorporate oral health education as a part of classroom instruction.
• The program model is presented is to elementary schools with support from organized dentistry, local dental school faculty, their students and community volunteers. It is important that dentist examine and provide treatment for underserved children.
• Exposing dental students to programs like Lessons In A Lunch Box may help to improve the access to the oral health care challenges we face throughout the country.
• Further, the profession of dental medicine is facing a workforce shortage. According to the 2000 Surgeon General’s Report, by 2020 there will be one dentist for every 100,000 Americans. The program places emphasis on encouraging children to begin considering the dental profession as a career option. 
• The ideal times during the school year to introduce the Lessons In A Lunch Box program are:
• October, National Dental Hygiene Month. This is a good time of the school year to present the program because it allows the teacher approximately 8 school months to refer to the visual and practical lessons offered by lunch box.
• February, National Children’s Dental Health Month (NCDHM). This is another great time because much of the dental community looks forward to participating in initiatives that highlight and support the annual observance of NCDHM when dental and medical professionals focus on efforts to improve the oral health of children.
• Give Kids A Smile® (GKAS) Day. Usually celebrated throughout the country in late January or early February, GKAS is the annual centerpiece NCDHM.
• The cafeteria has proven to be the best location in the school to present the program. Students can comfortably have their lunch box open in front of them while listening to the presenter explain all of the fun and exciting educational features of the delightful container. They learn about the following:
• flossing, brushing and fluoride
• healthy dietary choices and good eating habits
• careers in dentistry

Did you learn anything new here? By partnering and supporting this expansion, we learned a lot about the vision impaired community and successful ways to help all children develop important oral health habits.

Hispanic Heritage Month: Highlighting two organizations committed to oral health

As part of our commitment to meeting the different oral health needs for different populations, DentaQuest learns about cultural heritage through observances like Hispanic Heritage Month, which runs through Oct. 15. It is a month-long tribute to Hispanic Americans who have so richly contributed to our society, and to the cultures, languages, and traditions passed down by their ancestors. DentaQuest is committed to improving health equity and advancing solutions that meet the needs of the many different people our plans and services touch, in part by supporting the efforts of local organizations.

While the contributions of our Oral Health 2020 network partners are as diverse as the communities and the perspectives they represent, and impactful in so many important ways, we’d like to take a moment to acknowledge two of our grantees who are working in this way to improve the public’s perception of oral health, and bringing the voice of Hispanic and Latino* communities to the table.

We know that the only way to develop targeted solutions and ultimately achieve better oral health for all is to engage those people who are most impacted. One of the goals of Oral Health 2020 is to improve the public’s perception of the value of oral health. We want everyone, not just dentists and hygienists, to recognize and understand the importance of the health of the mouth to the health of the rest of the body. With this important understanding, we will continue to mobilize communities across the country to rally together to advocate for better oral health.

In California, Vision y Compromiso is committed to improving community well-being by supporting promotores (liaisons between their communities and health and social service providers) and community health workers. Across 24 counties from Southern California to the Greater Bay Area, Vision y Compromiso’s network of promotores and community health workers is serving as a bridge for both native-born and immigrant people, and leveraging their shared language, ethnicity, culture, and experiences to reduce barriers to care and education. 

For example, together with Asian Americans Advancing Justice, Vision y Compromiso is spreading a campaign to educate individuals and families in the state on the health coverage available to anyone in the state, regardless of income or immigration status.  In just under two weeks, Vision y Compromiso will be bringing together these important stakeholders at their annual conference in Ontario, CA.

Also working on the West Coast is Latino Coalition for a Healthy California (LCHC). LCHC is one of the leading voices for Latino health in California, with a focus on initiating and advancing policies that help build healthy communities. With their ongoing work to address disparities in oral health, LCHC is focusing efforts on ensuring that affordable dental care is accessible to all Californians. 

Like Vision y Compromiso, LCHS is also working with promotores, training them to be both advocates and messengers for oral health and its social influences in Latino communities. LCHC is committed to elevating the voices of those in their communities to be heard by decision- and policymakers, in order to improve oral health at a systemic level. A recent initiative champions efforts that reduce access to sugar-sweetened beverages, which not only impact oral health, but also contribute to the disproportionately high incidence of diabetes in both adults and children in Latino communities.

We are so proud to support these and so many other amazing organizations that are working to improve the oral health of all. Please visit their websites to learn more:

Vision y Compromiso  

Latino Coalition for a Healthy California

*While “Hispanic” and “Latino” are often used and understood interchangeably, “Hispanic” focuses on Spanish-speaking origin, while “Latino” refers to people of Latin American origin.

Children's Health Insurance Program (CHIP) is vital for kids' wellbeing

September is a big month for kids – not only are they starting or heading back to school, but this year they also are taking center stage in Washington as Congress heads back from its own summer recess. Funding for the Children’s Health Insurance Program (CHIP) will expire at the end of September, meaning Congress must act swiftly to ensure continued, comprehensive medical and dental coverage for our nation’s children.

Nationwide, CHIP covers approximately 9 million uninsured kids (and in some cases, pregnant mothers) in families with incomes that are modest but too high to qualify for Medicaid. 

States administer the CHIP program in different ways. Your state may have a separate CHIP program, combine the CHIP and Medicaid programs, or include CHIP within Medicaid expansion initiatives. Although administered by states in a variety of ways, the federal government provides matching federal funds to all states and that funding is vital to the program’s continued success.

Historically, CHIP reauthorization and funding have enjoyed bipartisan support, with members of Congress working together to guarantee health care coverage for vulnerable children. However, with the hotly-contested debates over Affordable Care Act repeal and replace legislation, securing the future of the CHIP program may prove significantly more challenging this time around…

Congress must tackle a significant number of important issues in short order this September. 

Addressing the debt ceiling to avoid a government shutdown, authorizing Hurricane Harvey relief, and handling a Trump administration proposal to privatize air traffic control are all at the top of the list. But Congress cannot lose sight the importance of CHIP. 

Without a long-term solution, states will be left with uncertainty over the future of their health care programs for kids. If CHIP funding is not renewed, or not renewed by the end of the month, states will be forced to make difficult decisions regarding the enrollment of the children in their programs. Without this funding, some children will be left without any form of medical or dental coverage.

We have seen over time that coverage leads to care and access to appropriate dental care is vital for children. In particular, tooth decay, the most common chronic disease among children, is degenerative without treatment and prevention, and research shows poor oral health impacts school performance and attendance.

But CHIP’s importance extends beyond oral health. 

For example, recent research indicates that treatment of gum disease can lead to better overall health management—as evidenced by lower health care costs and fewer hospitalizations—among people with common health conditions, such as type 2 diabetes. Ultimately, Congress must understand the gravity of their decision – coverage for children positions them well for a lifetime of optimal health and success. Don’t let politics put this at risk. Instead, let’s collaborate across party lines to quickly develop a sustainable plan that provides effective coverage for children and mothers in CHIP.

September 2017 marks the start of school and the start of what could make or break our children’s futures. This month is about ensuring our next generation is well-positioned to achieve optimal health throughout their lifetimes. As an organization committed to improving the oral health of all, DentaQuest strongly urges Congress to work together on CHIP funding and reauthorization in time to protect these vulnerable populations.

Make sure your voice is heard! 

Look up your Representative or Senator and ask them to renew CHIP funding and support long-term, sustainable solutions to protect our children’s health care.

Do you know if you have sleep apnea? An eye exam may tell you

Sleep apnea is a lot more common than you might think, and it is affecting your eyes and vision in drastic ways. August happens to be National Eye Exam Month and this is as good of a reason as any to go get checked out.

There are three types of sleep apnea, but most people suffer from Obstructive Sleep Apnea (OSA), which makes up 84 percent of sleep apnea cases.

To find out why that matters, let’s layout a quick biology overview:

Our bodies need oxygen – we inhale it, our lungs hold it, our blood picks it up from the lungs and takes it to all of our cells and tissues. Every organ needs it. The brain, for instance, uses 25 percent of your oxygen intake. Without enough, your brain function declines.

OSA occurs when the soft tissue of the throat collapses and blocks the airway. It happens continually throughout the sleep cycle.

The blocked airway means you aren’t inhaling enough oxygen for your blood to carry throughout your body (decreased blood oxygen). The pause in breathing—called an apnea—can last anywhere from seconds to minutes. The brain then signals the body to wake up and breathe.

OSA is most common in overweight or obese men. It occurs in approximately 24 percent of men and 9 percent of women. African Americans also have a 2.5 times higher risk.

• Other factors that may predispose us to this condition include:
• Age – over 40
• Smoking
• Neck circumference over 19 inches (Trivia: OSA occurs in 34 percent of NFL linemen!)
• Some of the most common signs and symptoms include:
• Snoring – although not everyone who snores has sleep apnea
• Daytime sleepiness – do you nod off at work; maybe it isn’t that you are just bored?
• Cognition problems – losing your train of thought sporadically
• Restless sleep – do you toss and turn a lot?
• Loved ones mention you seem to stop breathing in your sleep

Despite its relatively high rate of occurrence, OSA goes undiagnosed in 80 percent of the men and 90 percent of the women who suffer from the condition. High rates of undiagnosed patients may be due to the fact that the best test—a sleep study—is both inconvenient and can be expensive for patients.

Sleep Apnea and the eye

An association of OSA and eye and vision problems is very common and often missed during any type of eye exam or physician visit. At your next eye exam, consider if you have any of these symptoms and share them with your provider. You may help them catch something they otherwise might miss!

There are three common eye-related OSA side effects to watch for:

• Floppy eyelid syndrome – this is the most common and the easiest to miss during your eye exam. The person often wakes with scratchy or irritated eye(s) and some mucus discharge (some people refer to it as crusty eyes) that comes and goes over a long period of time. Close to 100 percent of people with floppy eyelid syndrome have some form of OSA.
• Keratoconus – the person experiences irregular astigmatism and chronic blurred vision that glasses only partially correct.
• Glaucoma – everyone should be tested for glaucoma. Its association to OSA is often missed. If a provider suspects someone has glaucoma, and also has any risk factors for OSA, they should consider further screening.

OSA is not harmless – get checked.

OSA is not a benign condition; as such, be aware of this condition especially if you have any of the common risk factors. This condition is a lot more common than you think and will take its toll if not treated. Since OSA so often goes unrecognized and misdiagnosed, mention any of the common signs and symptoms to your eye doctor and your family doctor. 

Special thanks to EyeQuest Vision Director Dr. John Davis for contributing this post!

Friday Federal Roundup: CBO, CHIP, and More

As a partner to states and the largest Medicaid / CHIP dental benefits administrator in the country, we at DentaQuest must stay updated on the latest health care policy trends - in large part because anything in the health space affects the oral health space.

Recent federal health reform proposals could have significant implications for Medicaid programs, exchange populations, and oral health coverage for low-income families. We keep our employees apprised of the latest happenings in Washington D.C. with weekly federal newsletters, and thought this week was particularly relevant for more than our staff.

Here’s this week’s newsletter.

CBO Releases Report on Subsidies 

According to a report released earlier this week by the non-partisan Congressional Budget Office (CBO), insurance premiums for ACA plans would rise 20 percent next year and in some areas of the country, people would not have any insurance options if the Trump administration scraps key ACA subsidies. Trump has repeatedly threatened to pull the ACA subsidies, particularly since Congress failed to pass repeal and replacement legislation before the summer recess. CBO’s analysis also found that eliminating the payments would increase the federal deficit by $194 billion over a decade because of higher spending on premiums subsidies. Trump must decide by early next week whether or not to make next month’s payment.

Congress Turns Attention to CHIP

Funding for the Children’s Health Insurance Program (CHIP) expires September 30th. With Congress out on recess, this leaves few legislative working days to ensure that nearly 9 million children maintain their medical and dental coverage. While CHIP reauthorization has historically been a bipartisan issue through the years, the hotly-contested debates over ACA repeal and replacement have left state officials anxiously awaiting assurances from Capitol Hill that 2017 will be no different. We will continue to monitor federal discussions on the future of CHIP and advocate where possible for the vital inclusion of dental coverage in reauthorization efforts.

Trump Administration Encouraging Medicaid Redesign Efforts, State Innovation

As Congress takes a pause on repeal and replacement efforts while they are on recess, states are looking to the Trump administration in the interim for more regulatory flexibility. CMS is expected to soon approve a Medicaid waiver from Kentucky which among other things would require most Medicaid-eligible adults to work as a condition of receiving coverage. Arizona, Arkansas, Indiana, and Maine are considering similar work requirements. HHS Secretary Tom Price and CMS Director Seema Verma have both expressed that they are in favor of such Medicaid redesign proposals.

Last month Alaska became the first state to get increased flexibility from the administration to prop up its individual marketplace with a reinsurance program. Minnesota, New Hampshire, Oklahoma, and Oregon are some other states that have already filed or are considering similar waiver proposals to submit to CMS.

HHS Proposes to End Obama-era Payment Programs

HHS Secretary Price has announced plans to eliminate two Obama-era Medicare bundled payment programs and scale back on a third. This proposal would cancel initiatives that make hospitals more accountable for the cost of certain joint replacement surgeries and cardiac care, and shrink an existing program covering hip and knee surgeries. This is considered a victory for providers who oppose requirements to participate in new payment models. We will continue to monitor whether or not HHS will take further action to roll back requirements in order to slow down the transition to value-based reimbursement structures.

‘Action for Dental Health’ in Congress

While we all paid close attention to health care in the Senate last week, the House Energy and Commerce Committee made a critical, yet mostly overlooked step to advance oral health for at-risk populations.

On July 27^th, the Committee unanimously passed HR 2422, or the Action for Dental Health Act of 2017. This bill calls for Congress to authorize additional oral health promotion and disease prevention programs to help at-risk populations struggling to obtain appropriate oral health care.

The bill points out that more than 181 million Americans will not see a dentist, but almost half of people ages 30 and older have some form of gum disease and nearly a quarter of children under age 5 already have cavities. 

As we at DentaQuest well know, caries is the most prevalent chronicdisease among children and can be prevented. What’s more, we see time and again that Americans of all ages are in desperate need of access to oral health care - Missions of Mercy like the one in Wise County, Va., is a great example. Both the Washington Post and The New York Times covered the July event, for which thousands of people come from miles away and lineup for hours and even days just to get access to dental and other services.

If this new legislation passes through Congress, the Centers for Disease Control and Prevention will award grants and collaborate with states, counties, public officials, or other stakeholders to implement a variety of initiatives.

These activities could include oral health programs that:

·         more broadly use portable/mobile dental equipment;

·         facilitate the establishment of dental homes;

·         eliminate geographic, language, cultural, or other barriers to care;

·         reduce the use of emergency departments for dental conditions; and

·         provide dental care to nursing home residents.

It is exciting to see bipartisan support for dental care initiatives that have tremendous impacts on the oral and overall health of patients. This type of work will drastically improve the health of Americans. And it has the ability to address the estimated $2.6 billion in free care that dentists currently deliver, as well as the nearly $2.1 billion spent on dental cases in hospital emergency departments – 80 percent of which could be treated in a dental office for roughly $4 million total, according to the bill.

Bipartisanship like this must continue and we urge legislators to make oral health a critical component of any health reform legislation that passes through this Congress. 

Congress: Protect Access to Dental Health Care

As the Senate debates health care bill proposals to transform our care delivery and financing systems, we must ensure they protect access to dental coverage for all Americans.

Over the past few years, more and more Americans have been able to access affordable dental coverage. In fact, since 2000, the percentage of children without dental coverage has been cut in half.

Medicaid has played a critical role in this progress. Dental services are considered an essential part of the Early Periodic Screening, Diagnostic and Treatment (EPSDT) program, which ensures that children receive regular dental care. Adults have also benefited in recent years, with 5.4 million adults gaining coverage through Medicaid expansion.

Other public programs have also helped. Because pediatric dental benefits are considered an essential health benefit on the exchanges, more kids have coverage. Further, many adults have selected dental coverage through the marketplaces.

As more of us gain access to coverage, we see the rate of untreated decay declining among low-income children, and research shows that costly emergency department visits for dental-related issues have declined. These improvements are in large part attributable to the fact that more people have access to dental coverage.

Over the past several months – continuing this week and for likely the near future – Congress has explored various avenues for health care reform. The value of oral health care and dental coverage cannot be overlooked in these conversations.

Let’s not overlook that tooth decay remains the most chronic condition among children, which can affect school performance and attendance.

Additionally, optimal oral health is not simply a goal in itself, but is vital to creating healthier communities. Research has shown that tooth decay can result in an elevated risk for diabetes, heart disease, and stroke. What’s more, recent studies demonstrate that treatment of gum disease can lead to better overall health management—as evidenced by lower health care costs and fewer hospitalizations—among people with common health conditions like those mentioned above or even pregnancy.

Any health care reforms must ensure dental remains a priority.

By improving access to dental coverage for low-income families in the past few years, we as a nation have made tremendous strides to

• ensure children are well-positioned for a lifetime of optimal health;  

• decrease poor quality, high-cost emergency department visits for dental-associated issues; and

• improve the oral and overall health of vulnerable populations.

We hope Congress pursues solutions that protect these improvements.

DentaQuest Foundation grassroots grantees ready to leap for oral health

I recently heard the perfect analogy for our oral health advocacy during the DentaQuest Foundation’s Grassroots Engagement Strategy annual meeting. It’s a saying gardeners have about the growth process of perennials: “The first year they sleep, the second year they creep, then the third year they leap!”  This year is the year for the grassroots organizations and their partners to leap!

DentaQuest Foundation’s Grassroots Engagement Strategy started in March 2015 as an initiative to engage those most directly impacted by oral health inequities. Focused in six key states - Arizona, California, Florida, Michigan, Pennsylvania, and Virginia - the Grassroots Engagement Strategy leverages an existing network of key oral health advocates and stakeholders operating at the state level. The DentaQuest Foundation has funded 20 community-based organizations within these states to provide oral health outreach and take action on social justice and oral health equity, all with the goal of improving public perception of the value of oral health in their communities.

These 20 grantees represent deep and diverse experience working directly with community members and contribute essential perspectives of community advocacy and action. They are providing community-grounded voices within a broad group of stakeholders at the state, regional, and national levels, a perspective that is critical if we are to reach our mission of improving oral health for all.

The Grassroots Engagement Strategy has now entered its third year of development, and the purpose of the annual meeting this spring was for grantees to learn from one another about what has been accomplished in the last year, what is planned for the year ahead, and how to deepen the commitment to health equity.

On day one, each organization presented its community-driven plan that covered stakeholders, how they have incorporated the Oral Health 2020 goals into their communities, 2017 organizational priorities, their proudest moments, and their greatest challenges.

For example, one organization discussed advancing a legislative advocacy strategy around protecting oral health equity policies, while dealing with the major challenge that oral health is not a top priority for the community members facing other economic and social challenges.

On day two, many of the Oral Health 2020 national advocacy partners presented the resources and tools in development that will support the grassroots organizations in their work. Attendees also discussed how they can learn from one another and build their capacity to make change at the community level.

Additionally, there were presentations on different approaches to advocacy and lobbying, including how to provide empowerment opportunities for community members in advocacy and public policy.  Partners also discussed how they work collaboratively with other organizations to activate coalitions and networks that share common goals.

The underlying themes throughout the discussion:

• health equity 
• the link between oral health and other social determinants of health 
• the implications that these have 
• who  needs to be at the table  

Similar to previous years, the grassroots organizations returned home with a sense of rejuvenated momentum for oral health.   Words like “motivated,” “energized,” and “connected” were used by attendees format the close of the meeting.  With the political landscape changing, the role of grassroots organizations engaging in advocacy is even more critical at the local, state and national levels.

When community members are educated on the topic of oral health and have the passion and understanding of its impact, their voices are powerful.  

The Oral Health 2020 Network is excited to see the progress that will continue in these communities and beyond. The grassroots grantees are ready to “leap” into action for year three of the Grassroots Engagement Strategy!

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Guest post from DentaQuest Foundation's grants team member Liana DiRamio. Learn more about the grants and programs here: http://dentaquestfoundation.org/about/our-mission. 

DentaQuest Remains Voice for Oral Health Equity in Disparities Leadership Program

For the second straight year, DentaQuest is participating in the Massachusetts General Hospital’s Disparities Leadership Program. Last year, DentaQuest became the first oral health organization to be accepted into the program. Over the next 12 months, we will build upon our previous efforts to promote oral health equity for Medicaid and CHIP populations.

The Robert Wood Johnson Foundation recently released a paper that defines health equity as “the ethical and human rights principle that motivates us to eliminate health disparities,” both a process and an outcome.

Now in in its 11th year, the program gathers a variety of health care leaders to develop strategies that address disparities in health care. We are particularly excited to remain part of this team, which is designed to cultivate leaders who can align equity efforts with the transition to value-based health care.

DentaQuest is one of five health plans in this year’s class and once again the only oral health organization. Our project will focus on how to leverage data and our national footprint to identify and alleviate oral health disparities, while also promoting equity as a key objective for our own organization.


Why is it important that oral health leaders are involved?

Despite progress towards a more equitable health care system, oral health disparities persist.

• Untreated dental disease is disproportionately prevalent among racial and ethnic minorities
•  42 percent of African American adults and 36 percent of Hispanic adults have untreated dental disease, compared to 22 percent of Caucasians
• Among adults with incomes below the federal poverty line, 42 percent have tooth decay—that’s three times more than adults with incomes above 400 percent of the federal poverty line.
• Rural areas experience higher rates of dental disease and tooth loss with lower preventive utilization rates.
• Barriers such as cost and fear of discrimination mean just 10 percent of the surveyed LGBT population say they have regular dental visits.

With much progress still to be made, the four branches of the DentaQuest enterprise—benefits administration, philanthropy, science, and care delivery—will work in tandem to reduce inequities in the communities we serves across the country. This work not only enables us to get closer to achieving oral health for all, but also will drive our work with others.

Ultimately, our participation in this program steps up our ability to address health equity collaboratively with our partners – from states and clients to providers and patients.

DentaQuest Institute Releases New Report on Interprofessional Care in Rural Communities

New white paper delves into the role of interprofessional networks to coordinate person-centered care and improve oral health

DentaQuest Institute, in collaboration with the South Carolina Office of Rural Health, the Medical University of South Carolina, the Colorado Rural Health Center, and the Pennsylvania Office of Rural Health, just released a new white paper , MORE Care: Narrowing the Rural Interprofessional Oral Health Care Gap. The report highlights the importance of interprofessional oral health networks in achieving person-centered care and population health improvement. By producing coordinated care pathways between dental medicine and primary and behavioral health, interprofessional oral health networks have the potential to improve patient outcomes, increase patient and provider satisfaction, and reduce the cost of providing and receiving care.

The report is the result of two years of collective findings from the Medical Oral Expanded Care (MORE Care) Initiative involving twenty-one Rural Health Clinics and fifteen rural dental care partners located in Colorado, Pennsylvania, and South Carolina. MORE Care partners provide insight into the main factors affecting the initiation of interprofessional oral health practice observed during the early phases of MORE Care.

The white paper, and a soon-to-be-released implementation guide, offer insight into the needs of Rural Health Clinics and rural dental care teams as they undertook the creation of interprofessional oral health networks (IPOHNs). In addition to creating interprofessional oral health networks, the purpose of MORE Care is to serve as a vehicle for adopting system change in the rural communities.

For more information on how dental programs serving rural communities can leverage MORE Care, contact Rebekah Mathews, director of transformation at rebekah.mathews@improvingoralhealth.com.

Healthy Vision Month reminds us to make our eyes a priority

May is Healthy Vision Month. With that in mind, we at eyeQuest encourage everyone to make eye health a priority and take steps to protect vision for a lifetime.

Vision might change as we get older, but vision loss is not a normal part of aging. Common eye diseases such as glaucoma, diabetic retinopathy, and age-related macular degeneration threaten millions of Americans, potentially robbing them of vision, mobility, and independence.

New technologies are making a difference, but early diagnosis, timely treatment, and appropriate follow-up care are essential to preventing irreversible vision loss.

Early stages of common eye diseases typically have no symptoms and can only be detected through a comprehensive dilated eye exam. If you are over 40, a dilated eye exam is recommended yearly, especially if you are at higher risk for eye disease.

As an example, Glaucoma, which causes “silent” damage to the optic nerve, is more common in people with certain risk factors such as African-Americans ages 40 and older; everyone ages 60 and older, especially Latin Americans; and people with a family history of the disease.

The number one cause of permanent loss of vision in people under age 60 is diabetic retinopathy. Also for people over 60, the risk for age-related macular degeneration (ARMD) rises significantly.
 
All of these conditions progress without any symptoms at all. The good news is that with early detection through regular eye exams, they are all manageable.  Vision loss is mostly preventable if treatment is started before the damage is done.

Recent clinical trials sponsored by the National Eye Institute have shown great progress in the prevention of AMRD-related vision loss. The latest study results (known as AREDS) determined that people at high risk of developing AMRD could lower their risk by about 25 percent by taking vitamins with certain antioxidants and minerals –  another reason to eat your spinach and other green leafy vegetables.

So, do your older self a favor and think about how important your vision is during healthy vision month. If it has been more than a year since your last eye exam, schedule an appointment and then ask your eye doctor about any of your risk factors. Awareness and regular eye care can make a difference. Much like regular dental care!  

Make healthy vision last a lifetime. During Healthy Vision Month, encourage friends and family to make eye health a priority. For more information about keeping eyes healthy, visit https://www.nei.nih.gov/hvm/ and download a healthy vision month toolkit.

Guest post from eyeQuest Vision Director Vidya Baliga

National Minority Health Month: A Thank You to Community Health Promoters

During National Minority Health Month, we’re calling attention to barriers many people must overcome to enjoy their best health, and the advocates who help them. 

One of our jobs as a leading health care organization is to help people understand what they need to do to stay healthy – and that starts with literacy.

Literacy skills are one of the strongest predictors of oral health status – stronger than age, income, employment status, education level, or racial/ethnic group.  It is estimated that at least a third of adults in the United States have limited health literacy and nearly half of all American adults - 90 million people - have difficulty understanding and using health information. Because of that, folks delay taking action, and before long, small problems become big health issues.  

Community health workers are stepping in to help people understand and navigate our health care system. It’s a very personal approach to health education. DentaQuest’s outreach team spends a lot of time in the community talking to people about oral health and explaining dental benefits and how to use them. National Minority Health Month gives us an opportunity to talk about the importance of community health workers — promotores*, or  outreach specialists. These committed team members are doing incredible work to bridge health equity across communities.

Community outreach specialists are hyper grassroots, frontline public health translators. Using the strength of their personality; personal contacts; trust; and an intimate understanding of the community’s strengths, needs and social networks, they tackle sensitive health topics, correct misinformation, and connect people with quality care.  In some parts of the United States, our certified promotores are at work in rural and urban areas at clinics, churches, workplaces, schools, and even around agricultural fields.

These outreach specialists are very important to achieving our goal of ending dental disease in children. An estimated 17 million low income children in the United States go without oral health care each year—that’s about one out of every five children. 

Outreach workers help figure out why that happens. It might be because the families don’t know they should seek dental care for the children. It could be because the caregivers don’t know where to find a dentist. And it could be that the parents simply fear going to the dentist and share that fear with their kids. Outreach workers calm fears, educate and guide caregivers, and help them navigate the complexities of our health care system. They introduce families to preventive services, and even check back to be sure treatments that are initiated get completed.

And it’s not just for children. Regular screenings and preventive education for people of all ages reduce poor health outcomes and health expenditures. Outreach specialists help adults understand systemic health – what smoking does to the body or how managing mouth disease helps control diabetes and heart disease, for instance. It’s the trusting relationship with the community that enables outreach specialists to cross the cultural divide and get people involved in disease prevention and wellness. This is a critical role, especially where language, transportation and cultural responses are barriers to health.

National Minority Health Month - with this year's theme of health equity - is an opportunity to acknowledge the dedicated work of our promotores / outreach specialists and to give thanks for their genuine servicio de corazon (service from the heart).

Thank you for all you do to advance health equity nationwide!

*Promotores de salud, also known as promotoras, is Spanish for “community health worker.” 

Prioritizing Our Seniors: Why Offering Medicare Dental Coverage Matters

More than 46 million seniors lack dental coverage, according to a 2015 report on enrollment from the National Association of Dental Plans (NADP) and Delta Dental Plans Association (DDPA). And that number is only expected to rise with our burgeoning population of older adults.

In order to help more seniors get covered, U.S. federal policy must more effectively address the oral health needs of this population.

Recently, there have been several big news stories about the barriers 70 percent of seniors face to receive quality oral health care.

One major contributor is that dental care is not covered under Medicare. Boston College researchers found that the percentage of people with dental coverage declines by more than half in the 10 years after reaching retirement age -- from 62 percent at age 65 to 26 percent at 75. Why? According to CBS News, the study suggests the following...

The reason: When most workers retire, they lose the dental coverage provided by their employer or union. But doesn’t Medicare, which starts at age 65, step in and pick up the slack? Not on your canines, “a fact that a majority of baby boomers are unaware of…”

According to a recent survey of 2,000 registered U.S. voters conducted by DentaQuest via Morning Consult, this is not a partisan issue. In fact, 83 percent of Republicans and 86 percent of Democrats responded that dental coverage should be included in Medicare.

Without coverage, seniors face significant out-of-pocket costs to obtain appropriate oral health care, as they are more likely to need the most costly procedures, such as crowns, implants, or false teeth as they age. Seniors are also more likely to have chronic conditions that may complicate or exacerbate these oral health issues.

Because traditional Medicare does not provide dental coverage, Medicare Advantage plans are taking a lead in providing oral health coverage for seniors. In fact, DentaQuest partners with many of these plans because they recognize the importance of oral health to the overall health of older adults. However, these benefits are optional or supplemental and not all seniors can afford to pay out of pocket for this coverage.   

More affordable solutions are necessary to bridge this gap for our seniors.

With all of the discussion surrounding changes to the Affordable Care Act and Medicaid, policies to expand dental coverage have largely gone overlooked. However, DentaQuest has taken steps to begin addressing this gap.

A few weeks ago, the DentaQuest Foundation announced a $668,000 grant to Oral Health America to expand the Wisdom Tooth Project and increase advocacy for publicly funded dental coverage for seniors. This project focuses on five strategies including education for seniors and professionals and pilot demonstration projects to combat barriers to care. The DentaQuest Foundation has been pivotal in supporting Oral Health America’s efforts for older adult oral health since 2010.

As health care prepares to undergo substantial changes, industry stakeholders may support different proposals but our goal should remain the same. We echo AHIP’s comments that the industry must bond together “to ensure every American has access to affordable coverage and quality care so they can achieve their best health.”

Expanding access to health care, including oral health care, is a foundational pillar to achieve this goal.

We cannot leave our seniors behind.

Building Health Literacy with Read Across America

If you’ve ever read a book with a child, you know the feeling of joy that comes from the experience, as well as how fundamental literacy is for people of any age.


So it is a source of pride that DentaQuest staff from coast to coast are joining teachers, celebrities, community members and parents in getting kids excited about reading through the National Education Association's (NEA's) Read Across America Campaign, a celebration of reading timed with the birthday of Dr. Seuss.


As health industry professionals, we have a responsibility to educate consumers so they can be active advocates for their own health. In its health literacy fact sheet, the CDC says 9 out of 10 adults struggle to understand and use health information, especially when it is unfamiliar, complex or jargon-filled. In fact, low literacy contributes to poor health outcomes, higher rates of hospital utilization, and less frequent use of preventive services, in addition to overall higher health care costs.


According to the National Center for Education Statistics, since 1993 just 53 to 58 percent of children ages 3 to 5 years read or were read to on a daily basis.


Simply reading daily with a child is important.

• Children who are read to at home have a higher success rate in school. 
• Children who read frequently develop stronger reading skills. 

As part of this year’s NEA campaign, our staff is visiting schools in:

• Columbia, S.C.; 
• Locust Hill and Richmond, Va.; 
• Lincoln, Neb.; 
• Milwaukee and Mequon, Wisc.; 
• Austin and Red Rock, Texas; 
• Doral, Fla.; 
• Snoqualmie, Wa.; 
• Anniston, Ala.; and 
• the Greater Boston area. 

We are reading one of three fun books --Throw Your Tooth on the Roof by Selby B. Beeler, The Tooth Book by Edward Miller, and Open Wide by Laurie Keller. The school’s library will also get the book to keep for future reading.

In Locust Hill #VA, Jackie wowed #HeadStart kids Middlesex Elementary with tales from The Tooth Book. #healthysmiles #READACROSSAMERICA pic.twitter.com/NU6kXJMrm4

— DentaQuest (@DentaQuest) March 1, 2017

Staff who have already visited classrooms said they felt like rock stars and oral health ambassadors. The children loved the facts we shared about their teeth, including how they should take care of their own teeth and gums.


Dental disease is the most common chronic childhood disease – and it is preventable. Introducing children to fun facts about their mouths, teeth and gums through the books we brought for Read Across America is a strong step in building the health literacy skills and disease prevention awareness that will empower this next generation of consumers to be health-knowledgeable adults.


Efforts like these will go a long way to helping us achieve our vision of being a nation where children can grow up free of dental disease.

Let's Talk Water Fluoridation this Children's Dental Health Month

In addition to Valentine’s and Presidents’ Days, February also marks National Children’s Dental Health Month, with a theme this year connected to fluoridation.

Dating back to February 1941, the month-long celebration brings together dental professionals, health care providers, educators, policymakers and more stakeholders to promote the benefits of good oral health for children through various activities and events.

This year’s campaign slogan is “Choose Tap Water for a Sparkling Smile,” focusing on the value of fluoridation.

Fluoride combines with enamel on the tooth’s surface to make it stronger, better able to resist decay, and prevent dental caries —the most common chronic disease for children.  

Over the years, research has supported the value of fluoridation:

• In 2013, the U.S. Task Force on Community Preventive Services found that on average fluoridated water increased the number of people in a community without dental caries by 25 percent. 

• A 2010 American Journal of Public Health article indicated that a child who consumes fluoridated water is less likely to have lost teeth from decay 40 to 50 years later in adulthood. 

Water fluoridation, since it requires passive action to show effect, offers a simple solution to contain total oral health expenditures, improve population health, and set children up to have better oral health as adults.

Water fluoridation benefits the entire community, regardless of status or background, which is critical to addressing ethnic, geographic, and socioeconomic barriers to effective oral healthcare—a widespread problem in the United States.

National Institutes of Health data indicates that 20 percent of White, non-Hispanic Americans have untreated tooth decay compared to 40 percent for Black, non-Hispanic Americans and 38 percent for Mexican Americans.

This data also showed that individuals below the federal poverty line (FPL) are almost three times more likely to have untreated decay compared to those making twice the FPL or above.

This makes dental disease a disease of disparities, which can be prevented, in part, by easy and free access to fluoride.

Fluoridated water is an evidence-based, cost-effective path to promote health equity and, as an oral health organization committed to improving the oral health of all, it is just another reason DentaQuest celebrates National Children’s Dental Health Month.