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.

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.

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.

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.” 

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.

Why are dentistry and oral health care practices seemingly easy to question?

The topic of evidence in dentistry and oral health care has been in the news a lot recently, with articles like this column in the New York Times by a professor of pediatrics.

In his column, Aaron Carroll discusses the differences he sees between his own and his wife’s dental journeys, as well as what little rigorous research has been done to support certain generally recommended dental practices.

What is interesting is that articles like this one and the popular flossing article from the Associated Press, among others, imply that recommendations made by dentists are based solely on limited or weak evidence – or worse, based simply on what the dentist will get paid for by an insurance company.

They also leave readers feeling that plaque removal and cavity prevention/treatment are the only elements necessary to address for good oral health.

Ultimately, Carroll suggests in his column that while lack of evidence doesn’t mean oral health prevention efforts don’t work, we should invest in research to ensure that those things we do are evidence-based.

For those of us in the business of improving oral health, we couldn’t agree more with that conclusion. But let’s take a closer look at some of the points that may have gone overlooked by recent press coverage.

We know that evidence something works for populations doesn’t directly translate into solutions for a specific individual – that is in fact why Carroll and his wife have such dramatically different dental journeys.

Carroll notes he has had just one filling in his life and doesn’t religiously care for his mouth, while his wife has “more fillings than [he] can count” but is fastidious in her oral care routines.

This underscores two important points:

1. Every person is different. Individualizing care is critical to improved oral health.

While evidence-based research informs standards of care, it is the dental team that must develop the best care plan for any given person’s situation. That is why DentaQuest invests in the development and adoption of evidence-based care protocols that focus on prevention, early intervention and disease management.

Our investments in disease management and risk assessment help provide dental teams with the knowledge and tools they need to best serve their patients.

For instance, across a five-year period, the DentaQuest Oral HealthCenter demonstrated that risk assessment and intense preventive efforts (including sealants and fluoride varnish) directly resulted in a reduction in the need for invasive surgical procedures.

Sealants are one of the most cost-effective strategies for protecting teeth, as noted in another recent New York Times column. This is because they provide a physical barrier against cavities. They can even be applied to teeth that are just starting to show signs of new cavities, and stop them from getting bigger.

The best time to seal a tooth is immediately after it erupts in the mouth, and so the DentaQuest Oral Health Center strives to set aside extra time at visits for children ages 6 and 11 since the permanent molars are usually erupting at that time. It is also why the DentaQuest Foundation collaborates so closely with school-based health alliances working to improve access to oral health care – and sealants – among children in grade school.

Additionally, with a patient population of over 10,000, the DentaQuest Oral Health Center works in collaboration with the DentaQuest Institute to refine strategies that make patients healthier. And when these best practices are implemented, they actively improve peoples’ health.

2. Prevention and oral health improvement do not take place solely in the dental chair.

Preventive dental visits provide an important opportunity for people to check in on their oral health habits and get evaluations for early signs of not just dental disease, but also chronic diseases like diabetes and hypertension.

Most of us spend two hours a year in a dental office. And, if we are to reconsider the benefit of two annual preventive visits as Carroll suggests, some of us might end up spending even less time with a clinician. So what about the other 8,758 hours?

The differences in the oral health of Carroll and his wife are not because he brushes with an electric toothbrush every day or because she is doing something “wrong” in her routine. Oral health care is more than just brushing and flossing. In fact, it is about more than your teeth and gums.

To make an impact, we have to take a look at how we pay for oral health care, how our public policies enable it, and how our communities prioritize it, in addition to how we provide it.

Addressing just one of those will not improve oral health care on the larger scale or reduce health care costs, as Carroll aims to do with his recommendations. We know oral health care is indeed critical for overall health. This is why we at DentaQuest look far beyond the dental chair.

For example, as part of Oral Health 2020, the DentaQuest Foundation is investing in efforts to incorporate oral health into the primary education system. Oral health education, screenings, assisted referral, and delivery of preventive care through our schools provide equitable, reliable entry into long-term oral health care.

DentaQuest also champions efforts to include innovative financing models for dental in person-centered approaches to care enabled by the Affordable Care Act (ACA).

Over the last decade, we’ve seen significant movement to transform our health care system into one that improves quality, lowers costs, and makes people healthier. In fact, on the medical side the Triple Aim is starting to be supported by alternative payment and care delivery models that are person-centered and focus on prevention.

Why did that happen? Because experts and advocates knew there had to be a better way forward for a healthier America.

The same is true for oral health. We are beginning to see that it is possible to live in a world where optimal oral health is the expectation, not the exception. We must continue to invest the same transformative energy into improving the oral health of all because you cannot have optimal overall health without optimal oral health.

 

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.