Hero Practice Services released a comprehensive research paper in October, titled “Protecting Children’s Oral Health Care,” which addresses children’s oral health care and how states can protect the most vulnerable as the nation recovers from the COVID-19 pandemic.
In the paper, Brian Bishop, D.M.D., dental clinical director for Hero Practice Services-affiliated dental practices, advocates necessary changes to current state and federal programs to increase access to care for low-income children:
• Tie Medicaid provider reimbursements more closely to private insurance rates to increase provider participation and patient access.
• Provide clear value-based incentive structures for providers to deliver preventive care, including oral examinations, dental cleanings, sealants and fluoride varnish.
• Increase educational programs for caregivers that reinforce the value of oral hygiene, diet and regularly scheduled preventive oral health care.
• Preserve programs for student loan repayment for dental providers treating primarily Medicaid dental patients.
“The paper really speaks to the heart of everything we do as an organization,” said Dr. Bishop, who co-authored the paper. “It helps paint a picture of disparities of care, in terms of access to care. Increasing awareness of the importance of dental health and access, as well as the utilization of dental services, are key messages throughout this paper.”
A reimbursement structure that ensures providers receive fee rates that are more closely aligned with commercial rates will result in a broader range of provider participation and effectively increase the amount of access for patients on Medicaid and the Children's Health Insurance Program, Dr. Bishop said. Ensuring that there is an adequate number of providers available for preventive oral health services for every child in every community will tend to result in lower health costs and better health outcomes over time, he added.
According to Dr. Bishop, when providers are not reimbursed at rates that are relative to the current market, research has shown that the cost to government payers increases due to the reduced number of dental providers accepting Medicaid, resulting in reduced access to preventive care and therefore an increased need for emergency or extensive restorative care over time. Access to preventive dental care at an early age is a factor to consider when evaluating the gap in oral health and rates of dental caries between children who have Medicaid insurance coverage versus children who have commercial insurance.
Research conducted by the ADA and the ADA’s Health Policy Institute was “invaluable” in creating the paper, including evidence-based information on dental loan repayment, the high cost of emergency room visits and the value and utilization of preventive care, including sealants across the country, he said.
To Dr. Bishop, advocacy and education are critical.
“There needs to be consistent messaging from the entire dental team — dentist, dental assistant and hygienist,” he said.