Some research has showed that treatment of gum disease in patients with diabetes can reduce the costs of their overall medical care. Similarly, treating a pregnant mother’s dental decay may reduce both a mother’s and a baby’s risk of developing complications and cavities later in life.
A bipartisan group of legislators, backed by the privately funded Washington Dental Service Foundation, wants to replicate for our state’s Medicaid patients what a United Concordia Dental study found for diabetes and pregnant women.
Senate Bill 5540, sponsored by Republican Sen. Maureen Walsh of Walla Walla, would invest $1.5 million of state dollars into a four-year partnership between the foundation and community groups to run the pilot dental program catering to low-income pregnant women and adults with diabetes.
The three-county pilot would be patterned after the successful Access to Baby and Child Dentistry program, or ABCD, which is a partnership between the state Health Care Authority, the University of Washington’s School of Dentistry, local dental societies, the foundation and community groups.
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Thurston County is one of three sites identified for the pilot. State funds would be matched by $750,000 from the foundation, which in turn is financed by the Delta Dental insurer, says Diane Lowry Oakes, foundation president and CEO.
The Thurston County piece would be managed by CHOICE Regional Network, which already administers an ABCD program that enlists local dentists trained to handle the youngest patients. Two other potential sites are being identified.
Getting public money for health care is going to be difficult in 2017, because the Washington Legislature is struggling to fully fund K-12 public schools and upgrade mental health care, both in response to court orders. And, there is uncertainty over the federal Affordable Care Act and Medicaid.
But early investments can pay off. The Dental Service Foundation reports that the percentage of Medicaid-covered children who got a dental visit has doubled in the last decade, and the incidence of untreated tooth decay among preschool-age children was down to 13 percent, half that of five years ago. It also found through ABCD, which started in 1995 in Spokane, that total costs for dental care during a child’s first five years is cut in half if care begins before age 1 rather than waiting until age 4.
The Washington State Dental Association is supportive of the idea. One barrier to care is persuading enough dentists to participate. Less than a quarter of Medicaid-eligible adults and half of eligible children received dental care in 2015, according to the foundation, and incentives should help get more dentists to step up.
The pilot would boost state reimbursements to about 42 percent of commercial rates for dentists taking these Medicaid patients. Oakes says current Medicaid reimbursements are about 29 cents on the dollar, making Washington fourth lowest in the country for dental payments.
Giving kids a clean start in life, boosting family health and curbing medical costs are all worthy goals. SB 5540 deserves support and funding in the two-year state budget.