d ental care in North Dakota Collaborative strategies to reduce barriers to care Why dont patients visit the dentist Fear Cost Transportation Low knowledge of value of oral health Not experiencing pain ID: 605470
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Slide1
Access to dental care in North Dakota
Collaborative strategies
to reduce barriers to careSlide2
Why don’t patients visit the dentist?
Fear
Cost
Transportation
Low knowledge of value of oral health
Not experiencing pain
Cultural factors
Language barriers
Lack of available workforceSlide3
Keys to expanding access to care
Education
Prevention
OutreachSlide4
25%
of the population
has
80%
of the dental disease
Who Are We Treating?Slide5
Half of ND Medicaid recipients reside in our four urban centers
Fully-staffed public health
dental clinics
Supported by state oral health programs, private practice
Medicaid providersSlide6
Medicaid-specific provider barriers
Reimbursement rate below cost of services
N.D. = 60% of usual fees
Claims admin complexity, delayed payment
2015 MMIS Medicaid transition
Lack of patient compliance
Rate of failed appointments = 30-50%
Despite these barriers, ND exceeds national averages in percentage
of
dentists
enrolled in Medicaid
plus
Medicaid
fee
reimbursementSlide7
Improving Access to Care
Collaborative Partnerships
Access to Care
Safety Net Clinics
Dental
Homes Private PracticesSlide8
Solutions?
Improve dental Medicaid
with adequate funding, reduced administrative burden, and vigorous dentist recruitment.
Expand and support non-profit safety-net clinics
through grant partnerships, loan repayment programs.
Maximize dental hygiene and assistant workforce
through expanded training programs, community outreach, and case management.
Engage with tribal communities
to improve
IHS dentistry, maximize prevention, reduce credentialing barriers, and facilitate contracting with dental community. Slide9
Current EffortsSlide10
Improve Dental Medicaid
Recruit more providers
75 dentists pledged to see more Medicaid patients
through 2015 “Take Five More” initiative
Work to close reimbursement gap
Reimbursement fees closer to market-based rates
likely to improve participation
Quarterly Medicaid Advisory Committee
meetings w/DHS Medicaid officials
Regular communication aimed at improving
Medicaid administration Slide11
Maximize Current Workforce
Seek in-state program
for expanded restorative
functions training
Expand school-based outreach
3,124 kids in 42 schools received sealants in 2015-2016 through
Seal!ND
Encourage case management
3 DAs completing Community Dental Health Coordinator certification
Support ER Diversion programs
Volunteer in mobile outreach, programs
Ronald McDonald
CareMobile
, Donated Dental Services, moreSlide12
Expand, Support Non-Profit
Safety Net Clinics
Recruit
workforce, volunteer dentists, support outreach for 6 existing non-profit dental public health clinics
Maintain
quarterly survey of ND dentists to match volunteers with non-profits
Promote
loan repayment, student exchange programsSlide13
North Dakota led nation in
net in-migration
of dentists from 2011-2016
Contributing factors were
state loan repayment programs,
WICHE Professional Student Exchange ProgramSlide14
Engage with Tribal Communities
Providing local dentist support for IHS clinics
Recruited 4 dentists to Spirit Lake Clinic in 2016,
filled need until FT dentist hired
Facilitating outreach on reservations
Supporting tribes that elect “638” statusSlide15
Future FocusSlide16
Improve Dental Medicaid
Continue fee reimbursement efforts
Collaborate with Governor’s office, DHS to
improve MMIS claims system, evaluate risk-based managed care organization (MCO)
18 states currently utilize dental MCO’s Slide17
Maximize Current Workforce
Utilize in-state training program
for expanded hygienist, assistant duties per NDBODE rules
Integrate case management
in all dental public health programs
Utilize $6.8 million ND Dental Foundation endowment
for outreach, education programs
Further expand school-based outreachSlide18
Maximize Current Workforce
Establish ER Diversion programs
in Bismarck, Minot and Grand Forks
Obtain grant, launch
teledentistry
pilot program
Obtain funding to support expanded distance-learning program
for dental assistantsSlide19
Expand, Support Non-Profit Safety Net Clinics
Continued workforce support
through recruitment, grant support, volunteerism
Emphasize loan repayment programs, WICHE Professional Student Exchange Program
Support integration of CDHCsSlide20
Engage With Tribal Communities
Provide staffing support
for IHS clinics as needed
Facilitate expanded outreach
through mobile
clinics, school-based programs
Provide support for tribes that elect “638” status
to contract directly for dentists, establish third-party billing
Support use of CDHCs
to assist in outreach, educationSlide21
Collaboration – The ND Way
Explore, implement
Medicaid Managed Care Organization Contracting
Integrate case management
at public health clinics
Funding, support
distance-learning, expanded functions programs
TeledentistrySlide22
Let’s work together to implement
North Dakota solutions
for good oral health
Brent Holman, DDS
Executive Director, NDDA
ndda@midconetwork.com
701-223-8870