Published July 2023
Improving Rates of Preventive Dental Care for MMC Adult Members Ages 21-64 Years
Low-income adults suffer a disproportionate share of dental disease and are nearly 40% less likely to have a dental visit in the past 12 months, compared to those with higher incomes. Poor oral health can increase risks for chronic conditions such as diabetes, heart disease, and tooth decay—currently the most common chronic disease in the US. The NYS Department of Health (NYSDOH) recognizes the importance of annual dental visits and good oral health for the Medicaid Managed Care (MMC) population. The current NYS PIP, Improving Rates of Preventive Dental Care for MMC Adult Members Ages 21-64 Years, aims to help improve preventive dental care rates among this population, by focusing on three areas:
- Annual dental visits (ADV)
- Emergency department visits for non-traumatic dental conditions (NTDC-ED)
- Social determinants of health (SDOH)
To align with the goals of the NYS PIP, MVP has partnered with Healthplex, facilities, and providers to increase ADVs, reduce NTDC-ED, identify and address SDOH affecting preventive dental care, and improve Member experience and access to appropriate care.
Based on partial 2022 data, MVP Members have made significant progress reducing NTDC-ED, but more work needs to be done to promote ADVs among the MMC population as ADVs are still experiencing a downward trend.
To help better understand some of the SDOH barriers keeping Members from having routine dental care, MVP conducted a survey among Medicaid Members ages 21-64 in the Northeast region. Among those who have not received dental care in the last 12 months, many (59%) noted the COVID-19 pandemic had at least some impact on their dental care. Barriers such as finding childcare, or transportation were mentioned less frequently. Now that the COVID-19 public health emergency has ended, there is an opportunity to help Members get back on track with their routine dental care.
Dental Care is Primary Care
Primary care teams can help Members understand the importance of oral health in the context of their overall health and reinforce the importance of annual dental visits and preventive care. Additionally, PCPs and their teams can leverage their skills, resources, and tools to intervene in the oral disease process by:
- Asking about the Member’s oral health, risk factors, and symptoms of oral disease
- Looking for signs that indicate oral health risk or active oral disease
- Identifying SDOH or local/regional barriers to dental care
- Deciding on the most appropriate response
- Offering preventive interventions, referral for treatment, and/or self-care practices