ADA House resolution encourages state programs to use DQA measures
Encouragement: Dr. Andrew Vorrasi, chair of the ADA Council on Dental Benefit Programs, listens at the November council meeting. CDBP is the lead agency representing the ADA on the DQA.
The ADA will also provide technical assistance to state societies to help them promote the use of these measures by their Medicaid agencies.
Resolution 89H-2013 was developed after the Georgia Dental Association raised concerns over the continued reliance on the Health Care Effectiveness Data and Information Set scores to measure for dental utilization.
GDA leaders believe the single dental measure in the HEDIS set commonly known as the Annual Dental Visit is misleading and doesn't clearly represent the level of utilization of dental services by children enrolled in Medicaid.
Currently, dental utilization in Medicaid is assessed using data from the Centers for Medicare & Medicaid Services through the form CMS-416 Early and Periodic Screening, Diagnostic and Treatment and through the ADV measure used by plans that contract with Medicaid programs.
"HEDIS measures utilization for children enrolled in Medicaid for at least 11 months of the year while the CMS set includes children enrolled continuously for 90 days. When you take into account the denominator population in each of these sets, the scores are very different," said Dr. Andrew Vorrasi, chair of the ADA Council on Dental Benefit Programs. "Moreover, neither the HEDIS nor the CMS data sets measure quality of oral health care. The DQA measures provide a mechanism to evaluate the complementary aspects of utilization, quality and cost."
In July, the DQA approved the set Dental Caries in Children: Prevention and Disease Management, which includes 10 tested and validated performance measures in oral health care.
The measures are: use of services; preventive services; treatment services; oral evaluation; topical fluoride intensity; sealant use in 6-9 years; sealant use in 10-14 years; care continuity; usual source of services; and per-member per-month cost.
"These measures were developed by the dental community and validated through a number of studies," Dr. Vorrasi said. "The DQA's current task is to promote these measures at the state level to continue to improve access to and utilization of dental services for children enrolled in Medicaid."
The DQA is continuing to strive to engage with other agencies developing measures for oral health to become the recognized leader. The DQA meets twice each year and is comprised of multiple stakeholders from across the oral health community who are committed to the development of consensus-based quality measures.
"Members sometimes feel that the ADA is not being proactive on an issue that, when it surfaces, causes the members to question the value of the ADA," Dr. Vorrasi said. "I am proud to say that the ADA and the House of Delegates have been on top of the issue of performance measures since 2008 and have taken every step possible to make sure that dental plans and programs are evaluated using appropriate standards."
To learn more about the DQA, visit the website.