Health Plans: How Reform-Ready Are You?

By Steve Pollock, DentaQuest Chief Operating Officer

The healthcare landscape is changing fast. In little more than a year, the Affordable Care Act (ACA) will require pediatric oral services as one of 10 mandatory categories of essential health benefits. This means that 23 million children across the country who currently do not have dental coverage will begin enrolling in oral health plans in 2014.

So what are the implications of this federal mandate on health plans? What components of dental benefit plan design, both front- and back-end do you need? And how do those managing health plans implement these changes?

On Oct. 16, DentaQuest addressed these questions and more when the New York Health Plans Association (NYHPA) hosted a webinar to give its members some perspective on the topic.  Though specific to healthcare reform in New York, the webinar addressed the broad effects of pending ACA mandates and what organizations should be doing now to prepare themselves for 2014.

In New York for example, 2.4 million children are currently without dental coverage and 79,000 are expected to enroll through the state’s health insurance exchange. This is new territory for most plans. However, we are one of the few dental administrators in the nation with experience in an exchange program. Drawing on that experience, the webinar gave New York health plans information to start developing their roadmap for this aspect of healthcare reform and what to look for in a dental partner.

Among plans throughout the country, awareness of the pediatric mandate has risen during the last year from 50% to 75%, and those tasked with managing these plans are starting to make important decisions about expanding the benefits they will offer. Our research shows most health plans view the upcoming changes to healthcare as an opportunity to provide their members with new benefit options and to expand their business.

Via the webinar, participants looked for guidance to assess opportunities in their market, to identify how dental benefits might provide a competitive advantage, and how to conduct an internal assessment to determine whether their current model will support dental benefits. They reviewed the data, asked questions of Dr. Rob Compton, Bob Lynn, and Arlene Saffron, and by the end of the webinar were armed with information to build a strategy for incorporating or expanding their dental program, while also meeting the ACA’s pediatric dental mandate.

We know health plans are feeling regulatory and competitive pressures. But we view the challenges of healthcare reform as a chance to share our insights as a reform-ready partner working across the full spectrum of consumers on and off exchanges, whether group and individual, Medicaid, Medicare, CHIP, or the dual-eligible population. Oral health is an essential part of good overall health, and we know the coming year is one of great change – for the better. Are you ready? We are. Let’s talk.

Clicking in to Oral Health

By Steve Pollock, DentaQuest Chief Operating Officer

We’re always looking for better ways to share DentaQuest’s innovations and improvements in oral healthcare. Our latest step forward is DentaQuest’s new website, which integrates DentaQuest’s corporate, government and mid-Atlantic websites and microsites with state-specific information, and more. This streamlined, updated web presence allows DentaQuest to bring concise, accurate oral health information to everyone who works with us: healthcare providers, benefits administrators, clients, members and people interested in good oral health.

We know dental benefits and oral healthcare are complex matters. We also know how vitally important it is to provide the information you need, exactly when you need it. We’ve revamped DentaQuest.com to be an efficient, easy-to-understand road map to better oral healthcare and benefits administration. 

First-rate service. Clear, concise information about oral healthcare management. Educational resources that forward our mission of “Improving the oral health of all.” DentaQuest is working – every hour of every day – to keep these goals at the forefront.

Since the new site was released in August, we’ve already seen visitors to the site increase by 55 percent. We hope the new website continues to bring in new viewers as we keep making improvements to serve you better.

What do you think? Tweet us @DentaQuest.

How Do We Integrate Value into Oral Healthcare to Consistently Improve Health?

By Dr. Rob Compton, Vice President, Business Intelligence, DentaQuest

Energized by the ongoing discussion of healthcare in America, we are witnessing an unprecedented shift in the way we think about care management. 

A particularly hot topic is the definition of value within the context of healthcare. How do we determine that optimal intersection of quality and affordability? And, perhaps most importantly, how do we – whether benefits providers, healthcare professionals, or patients – integrate value into oral healthcare in a way that consistently improves the health of the individual?

We know more care doesn’t necessarily equal better care, and that preventive measures haven’t always received their due. But the old mindset of “drill and fill” is fading fast. The question now becomes: what next? If we have the opportunity to create a new paradigm for oral healthcare, what does that look like and how do we manage it?

This is a challenging time – but one full of opportunities for innovation.

One such innovation is the way we are engaging all as partners in the goal of better health. This new, collaborative approach to oral healthcare rests on a foundation of proactive partnership between dentists, patients, and benefit providers. By offering enhanced benefits for higher-risk patients, data reports and a prevention-focused incentive program for our health care providers, along with educational resources for members, we’re seeing movement to better lifelong oral health.

This approach already is playing a vital role in care management. In a Massachusetts study involving a commercial PPO program, reports were sent to participating PPO dentists that identified patients who were more vulnerable to dental disease. Using these “Patient Prevention” reports, participating dentists were rewarded for their extra efforts to provide those patients with appropriate preventive care. After 12 months, collected data show a significant increase in the percentage of higher-risk patients in the program receiving recommended preventive treatments. 

The chart above shows the one-year results of what I believe is a breakthrough system of care. Children ages 6 to 18 who have had cavities are receiving fluoride treatments at an increase of 30%. Similarly, we’ve seen a 30% increase in the number of adult patients with gum disease who are receiving periodontal cleanings every six months. 

The numbers achieved so far through this collaborative approach focused on quality and value in care embodies our mission of “Improving the oral health of all.” We know dental disease is almost completely preventable, and we’re committed to eradicating it through best practices of prevention and early treatment. I’d invite you to find out more on the DentaQuest website. 

Our Mission: To Improve the Oral Health of All

By Fay Donohue

Today is one of those days when I think I must have the best job in the world.  This morning I’ll be addressing DentaQuest employees across our entire enterprise to speak about our mission, and to kick off a day of service where we will be working in communities across the country.  And all of this we do as we recognize and celebrate our corporate mission which is to improve the oral health of all.

Our employees are all motivated to engage in meaningful work in our local communities today. In Westborough, MA and Calverton, MD, Columbia, SC, Coral Gables, FL and Mequon, Grafton and Glen Oaks, WI and in Austin, TX and Boston, MA, DentaQuest employees will work together to make a difference and support our communities. We will be helping at middle schools, Boys and Girls Clubs, Habitat for Humanity sites and food banks.

As a company we understand the importance of preventive care and need to take a leading role in increasing access to quality, affordable oral health care. This day of service demonstrates our commitment to the communities we serve and underscores our passion to support healthy communities and help others.

Our mission is at the core of everything we do and stand for here at DentaQuest. Click here for interesting facts on this dental disease. Dental disease isn’t usually top-of-mind in the national conversation about health care—but it is a serious, chronic, infectious illness—and is preventable.

• Dental disease (cavities) is the most common chronic disease in children, more common than asthma.
• Every year across the United States, children miss 52 million school hours due to dental disease, and adults lose close to 164 million work hours.
• In 2010, Americans spent $106 billion dollars in oral care.
• More than 30 million people could not get treatment, including 1 out of 5 children.

During today’s “Recommitment to our Mission Day,” we will be supporting healthy communities across the country so more children have places to play and learn, more families have food to eat and a roof over their heads. And that’s part of our mission. A nation where no child suffers from the pain of tooth decay. Where adults keep all their teeth in good health for their entire lives. And, where every person has access to quality dental care.

Let’s Bring Back “Look Ma, No Cavities!”

By Dr. Doyle Williams

“Look Ma, no cavities!” seems to be a phrase of the past.

Recently the Australian Dental Association (ADA) suggested many Australian parents view dental problems as “the norm.” Studies revealed 60 percent of Australian parents surveyed accepted that their child would experience tooth decay, an almost entirely preventable disease, at some point in time. And Australia is not alone: tooth decay is the most common chronic illness among school-age children in the United States.

Tooth decay, the process that results in a cavity and occurs when bacteria in your mouth make acids that eat away at a tooth, can be easily be prevented by brushing and flossing twice a day, controlling harmful bacteria and maintaining a healthy diet. If tooth decay goes untreated, it can cause pain, infection, tooth loss and- in extreme cases- death in patients.

Parents have a challenging job. Instead of looking at brushing teeth as a burden, think of it as a relaxing two minutes of ‘me’ time.  Here are some ideas:

• Make brushing and flossing  a twice daily event – in the morning before you go out the door and as the last activity before going to bed
• Take your baby to the dentist by age 1 to be assessed for future cavity risk.
• Drink fluoridated tap water instead of plain bottled water.
• Cut down on sugary snacks, juices and sodas especially before bedtime.

If children sense their parents view dental problems as inevitable, they are likely to adopt the same belief and will be less likely to take pride in their oral health. Let’s take simple—but important--steps to bring back the phrase “Look Ma, no cavities!” and erase tooth decay. 

The Kids’ Healthy Mouths Campaign

By Fay Donohue and Ralph Fuccillo 

Every child deserves a healthy smile. That’s why DentaQuest is delighted to share a first look at the new Kids' Healthy Mouths campaign. DentaQuest is a partner in this exciting, new campaign developed by the Ad Council and the Partnership for Healthy Mouths, Healthy Lives, leading organizations in the field of oral health. 

                                                                         

(Video link: http://www.youtube.com/watch?v=oBfxQY8qs-E&feature=player_embedded)

The Kids’ Healthy Mouths campaign aims to educate parents and caregivers about how to improve oral health in children up to age 12 through simple, preventive strategies. Using entertaining public service announcements, the campaign highlights that it takes just two minutes of brushing twice a day to keep mouths healthy and help prevent severe tooth pain. 

With a focus on low-income and minority parents and caregivers, the Kids’ Healthy Mouths campaign offers 14 fun, two-minute videos their kids can watch while brushing, along with practical information about oral health. 

Accompanying the PSAs are 15-, 30-, and 60-second television spots, like the one above, as well as print advertising, all of which will be promoted via a wide range of media outlets.

Dental decay is the most common chronic disease of childhood. DentaQuest is driven by a mission to improve the oral health of all. Our vision is a nation free of dental disease, where no child suffers from the pain of tooth decay and where every person has access to quality dental care. 

Above is a sneak preview of the PSAs and 2-minute videos; we also encourage you to take a look at the Kids’ Healthy Mouths media materials.

We hope you will support this effort by sharing our news and these materials with your clients, friends, and colleagues.

A Celebration of Diversity: The Multicultural Oral Health Summit

Guest post by Carmen Fields, DentaQuest Foundation Associate Director National Programs       

Despite coming from different backgrounds and experiences, it was clear the hundreds of attendees at the Multicultural Oral Health Summit all shared a common vision: increased access to quality oral health services and improvement of oral health for all.

The first-ever joint convention of The Hispanic DentalAssociation (HDA), National Dental Association (NDA) and Society of American Indian Dentists (SAID) took place in sunny Boca Raton, Florida last month. I joined global health leaders, corporate partners, community leaders, foundations and others from all over the nation to discuss ways to “collectively meet the needs of a diverse population to improve oral health.”

The Summit began Friday (July 20) with a powerfully symbolic prayer by Dr. George Blue Spruce, founder of the SAID, and a posting of Latin American Flags by two dozen members of the HDA. The musical interludes during the opening program were especially refreshing, featuring a flute player from the Seminole Tribe of Florida and a gospel ensemble from the area.

I attended the Summit on behalf of the DentaQuest Foundation, which was recognized during the Summit’s opening ceremony for its ongoing support of the three multicultural dental organizations and for its commitment to improving oral health in underserved and diverse populations. I was joined by Fay Donohue, DentaQuest CEO and Foundation board member, who accepted the award. By collaborating with the HDA, NDA and SAID, the Foundation continues to help promote public policy and other initiatives to support optimal oral health for everyone.

The Foundation sponsored the Summit’s two-part President’s Symposium. The first presentation was rich and layered, with powerful presentations by University of Connecticut’s Associate Clinical Professor Sarita Arteaga, Foundation board member and Oral Health Alliance founder Caswell Evans, and Dr. Spruce. Dr. Joan Y. Reeve of Harvard Medical School was a terrific moderator, who framed the meeting as a provocative restating of the issues of health, focusing directly on dental care disparities. DentaQuest Foundation President, Ralph Fuccillo facilitated a presentation on how to improve oral health access. Take-away points from the discussions will become the basis for future messaging and an eventual strategy plan aimed to improve overall oral health care access.

While I attended many of the events at the Summit, two events in particular were unforgettable. At the Annual Women Dentists’ Awards Brunch (July 21), I had the pleasure of sitting with the founder of this symposium event, Dr. Marie Holliday of Dallas, TX, a Boston University and Tufts Dental School graduate. The group was organized to address the needs and concerns of African American female practitioners—and highlight and recognize their work. I also enjoyed The Civil Rights Luncheon, held Monday (July 23), which paid tribute to individuals who have fought for the civil rights and liberties of under-represented Americans throughout history. Orrin D. Mitchell, DDS, who helped pioneer in the fight against racial discrimination when he sought membership in the segregated Yacht club of Jacksonville, Fla. and Tom Joyner, whose syndicated radio show has been encouraging  good health (and now hopefully oral health) practices were awarded Civil Rights Awards. I was honored to be in the presence of so many distinguished leaders.

This historical event changed my perspective and made me hopeful for the future of oral health. Collectively, I have witnessed, that we can make a difference and help create brighter smiles for people of all walks of life.