Focus Area 1: Improved Access to and Utilization of Quality Oral Health Care Download Data

Indicator 1.1a3: % of Medicaid/CHIP Eligibles Enrolled at Least 90 Days receiving Any Dental OR Oral Health Service

37.42%2015

Partners

Incomplete list of critical partnerships identified to address underlying factors and garner support:

Florida Association of Community Health Centers • Florida Agency for Health Care Administration • Florida Department of Health • Florida Chapter of the AAP • Florida Department of Education • Florida CHAIN • Community Catalyst • Florida Legal Services • Office of the Governor • State Legislature • Human Services Organizations • Area Agencies on Aging • Managed Care Plans • Community Health Workers • Social Workers • Group Dental Practices • Insurance Groups/Managed Care • Hospitals • Primary Care Professionals • School Districts • Early Childhood Coalitions • Legislators • Lobbyists • Florida Head Start State Collaboration Office • Special Olympics Florida • Florida Dental Hygiene Association • Tribal Councils • National Dental Association • National Hispanic Association • Urban League

What Works

Increase and improve public awareness campaigns regarding oral health • Provide continuing education for oral health providers to increase proficiency regarding the treatment of vulnerable populations • Educate medical providers about the importance of oral health • Advocate for higher Medicaid reimbursement for dental care • Develop a statewide oral health surveillance plan

Strategy

Increase awareness and education among medical providers to increase the value of oral health as a part of general health • Expand focus of school health programs to include BSS oral health screenings and prevention services that can be provided by school nurses • Make referrals to dental providers • Assist medical patients to establish a dental home • The state is currently discussing replacing scoliosis screening with oral health screening. Lack of value oral health – messaging/oral health literacy as evidence based • Increase knowledge and broaden and leverage partnerships • Increase knowledge and information and broaden partnership on the value of oral health • Increase broad based support from other organizations affiliated with children's health (PTAs, PCP, head start, CMS) Promote increased participation of dental providers in managed care programs to improve access to care • Promote the expansion of medical insurance reimbursement to medical providers for fluoride varnish services • Improve Medicaid program performance through policy changes • Increase awareness and education among medical providers to include health sciences and educational programs to increase the value of oral health as a part of general health

Action Plan

Make referrals to dental providers • Assist medical patients to establish a dental home • The state is currently discussing replacing scoliosis screening with oral health screening. Identify effective messaging campaigns • Engage dental product corporations • Revise messaging campaigns to include cultural competency • Support a common provider application for credentialing for managed care organizations • Encourage AHCA to develop a customized participation program for Medicaid dentists (Replicate best practice models such as Texas) • Organize groups/stakeholders to create broad coalition support to increase utilization and therefore drive demand for increased reimbursement to providers • Encourage AHCA (or directly encourage managed care companies) to require managed care companies to decrease bureaucracy and increase percentage of claims that are reimbursed to providers via specific performance measures

Story Behind the Curve

Factors that have contributed to improving the data:

Access legislation promotes sealant programs • CMS prepaid dental has impacted preventive services • Additional children are being covered by Medicaid • Fluoride-varnish is being applied in health access settings • Collaboration between oral health and primary care is increasing • There is greater access to information about preventive dental care • Increased reimbursement rates • Fluoridation has increased across the state • Dental benefits promote preventive treatment • Managed care companies are focused on patient outreach

Factors that restrict the data:

There is a lack of access to preventive dental care due to its high cost and low percentage of individuals with dental insurance • Negative perceptions about dental care, painful experiences that result from acute conditions and fear al discourage people from seeking preventive treatment • People perceive dental care as acute and not preventive. • Generational and cultural differences determine belief about oral health • There is a shortage of providers because of: extremely poor Medicaid reimbursement • There is a lack of oral health funding • There is a lack of parental focus on children's oral health because of: lack of knowledge of importance of oral health; decreasing school oral health programs and health education • Dental is not integrated into overall health care • Unknown status around health equity • More education of consumers to seek services • Setting up transportation and appointments • Continued outreach to physicians to conduct preventive services and connect patients to dentists.

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