Written by Anne Bryce
If a group of dentists, policy makers, and health analysts have their way, North Carolina will revamp its oral health infrastructure and make regular cleanings and preventive care more accessible to hundreds of thousands of people. It will be.
The group believes that if regular dental care is more accessible to a large portion of the state's population, those at the bottom of the socio-economic ladder and perhaps in rural areas where health care workers are in short supply, the state's The research group said it could have a positive impact on health. .
For nearly 17 months, the North Carolina Institute of Medicine's Oral Health Transformation Task Force has been researching ways to make that happen. The group invited speakers, held conferences, and conducted interviews with numerous experts. Their hope is to strengthen the delivery of oral health care so that it is comprehensive and “seamlessly integrated into overall health,” according to a 118-page report published by the task force last month. It is said that there was.
Dream of the task force
“In the future, dentistry will make a significant contribution to improving health and exist in an environment where high-quality oral health care can go beyond siled care and complex management processes,” the report states. “This vision aims to transform oral health by putting patients at the center and emphasizing accessibility, equity and inclusion in the broader healthcare environment.”
The task force's vision complements efforts by dentists, dental hygienists, and oral surgeons over the past decade to dispel the notion that oral health is not inherently linked to systemic health. .
a little history
The separation between medicine and dentistry goes back centuries, according to one theory.
Some place the responsibility for this department on Pierre Fauchard, an 18th-century French physician often referred to as the “father of modern dentistry.” According to a 2014 WBUR interview with James Gutmann, editor of the Journal of the History of Dentistry, this discrepancy began in the early 20th century, when some began to view dentistry as more of a craft than a life-saving treatment. Some people connect them.
Studies have shown that tooth loss and periodontal disease are associated with heart disease and cardiovascular disease. Research shows that not having a healthy smile can negatively impact your employment prospects and negatively impact your mental health.
“Dentistry must be seen and practiced as an important part of providing excellent holistic health care,” said Steve, vice president of the North Carolina Oral Health Collaborative and a member of the task force.・Mr. Klein stated in the report. “Dentistry, like mental health, has traditionally been seen as a separate issue.
“Recently, the importance of mental health has become more openly talked about, resulting in significant institutional change and funding being directed towards it. Dental health also needs attention and support. The time has come.”
Want to learn more about Medicaid?
Areas the task force focused on included insurance models that create barriers to treatment and ways to increase the number of dentists who treat patients on Medicaid.
Dentists are lobbying for higher Medicaid reimbursement rates. The current rate (about 34 cents on the dollar) is the same as his 2008 rate. As a result, many dentists do not accept Medicaid patients.
Currently, only about 45% of dentists in the state accept Medicaid patients, and many of those that do are not accepting new Medicaid recipients.
When North Carolina expands Medicaid coverage in December, adding 600,000 more people to state and federally sponsored health insurance, these new beneficiaries will also be eligible for oral health benefits. The state's Medicaid program offers a comprehensive package of oral health benefits, including regular cleanings, exams, and other preventive services, but finding a welcoming health care provider is difficult for many. was.
Since Dec. 1, 451,194 people have been added to Medicaid enrollees, according to the Medicaid Expansion Dashboard.
With all these new beneficiaries, dentists and other oral health care providers are under pressure to accept more Medicaid patients. But many balk at the proposal, saying 34 cents on the dollar isn't enough to make the business model work.
Despite the shortage of dentists who accept Medicaid, more than $17.9 million in claims for dental services have been filed since Dec. 1, according to a news release issued Thursday by the governor's office.
Gov. Roy Cooper last month proposed a spending plan to lawmakers that would increase reimbursement rates for dentists for the fiscal year starting July 1.
Jay Ludlum, deputy commissioner of North Carolina Medicaid and head of North Carolina's $21 billion Medicaid program, told NC Health News this week that Cooper's spending proposal would reduce the number of people enrolled before the expansion. He said $45 million in additional state funds would be added to increase Medicaid reimbursement rates for the state. . More money would become available if federal funds were given to states to incentivize Medicaid expansion.
But spending decisions will ultimately rest in the hands of the General Assembly, the body that holds the state's purse strings.
Mental health model?
Ludlum acknowledged that at current rates, many dentists who accept some Medicaid recipients are providing charity care. “This is why we feel the need to raise rates,” he told NC Health News.
Importantly, Mr Ludlum, a member of the task force's steering committee, said it was trying to advance a broader conversation about how important oral health is to overall health. He likens it to the debate about the importance of mental health care that occurred during the pandemic.
Those discussions led to what state officials described as a “once-in-a-lifetime” investment in mental health services, with millions of dollars in state and federal funds poured into a vast array of programs.
“What we're trying to do is do the same thing for dentists,” Ludlum said.
The task force's report page includes a number of recommendations, including educational programs, collaboration with medical institutions and community groups, and the creation of a General Assembly task force to address some of the issues.
“Oral health plays a critical role in individual and community health outcomes and is closely linked to physical, mental and social well-being,” the report states. “Our state can ensure that patient needs drive investment and care decisions and that all residents have access to timely, personalized oral health care that complements the health of the whole person. .”