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

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.

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. 

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.” 

Let’s improve oral health with provider-focused, patient-centric Medicaid dental partnerships

States and managed care organizations face real challenges when it comes to running a successful Medicaid program and helping people get and stay healthy. Medicaid leaders find themselves faced with extremely difficult decisions about how best to prioritize critical needs of the population – often times there are no silver bullets. Yet, Medicaid dental partnerships are a great step forward.

In the past, the dental component of a Medicaid program has fallen victim to tough decisions, receiving fewer resources and lagging behind when it came to ensuring access to needed care. And people suffered.  

Recognizing this, states started to look at their Medicaid dental programs differently. They began seeking out industry experts like DentaQuest to help work directly with Medicaid agencies or to support managed care organizations to implement best practices. 

The result was that more people got access to the medically necessary oral health they needed.

   

Rapidly expanding regulatory requirements and Medicaid budget pressures, as well as the tidal wave of value-based payment and care models initiated by the Affordable Care Act, mean states once again find themselves at a crossroads when it comes to their Medicaid dental programs.  

Forward thinking states are moving past the notion that access to treatment is all it takes to improve the oral health of all. They recognize that an effective Medicaid dental program must achieve the Triple Aim: lower costs, improved population health, and better patient experiences.  

Tennessee is a perfect example of a dental partnership focused on the triple aim. 

In 2012, state Medicaid leaders recognized they were no longer meeting the oral needs of the people they served and set out to create a new Medicaid dental program model. They also recognized that they needed a new partner, not just a vendor, to help develop and implement a holistic approach to oral health.   

Today, DentaQuest partners with the state to administer the TennCare Medicaid dental program and through this partnership, more children have access to preventive care at a lower cost to taxpayers.  

Since partnering with TennCare in 2013, DentaQuest has saved the state $27.5 million by prioritizing preventive care, which helps to avoid extensive, costly future procedures. In the second year of the program, the number of children participating in the program increased by 8 percent to 810,000 enrollees. Through our dental home program, we’ve made sure that each and every one of the 810,000 children is connected to a dentist who is willing and able to provide care.  

TennCare has been able to handle the influx of patients thanks to a provider participation increase of 31 percent. DentaQuest has focused on easing the administrative burdens placed on providers and facilitating transparent communications.  

This successful model is built upon the idea that aligned incentives can improve outcomes.  

DentaQuest has a shared responsibility when it comes to improving outcomes and reducing costs. This challenge should not fall on providers and states alone. DentaQuest must meet outcome benchmarks—set by the state—related to access, network adequacy, outreach, and cost.  

DentaQuest met or exceeded benchmarks in all categories during the first two years and is poised to demonstrate success again in year three.   

The results of this model are encouraging: 

• Average distance to a provider is 3.7 miles, compared to a benchmark of 30 miles 
• Wait times for routine, urgent, and emergency care are significantly lower than the state’s thresholds 
• 100 percent of beneficiaries have patient-centered dental homes—providing accessible, comprehensive, and coordinated care to enrollees 

 

DentaQuest has been able to succeed in part by educating and engaging patients and families—even hosting over 80 community events last year.  

This type of patient-centric program should serve as a model for other state Medicaid programs and partners. Change and innovation should not mean complexity and burden. 

There is a better way forward and DentaQuest has a roadmap to get there.