Funder: DentaQuest Foundation and the Robert Wood Johnson Foundation

Author: Stacey Chazin, Center for Health Care Strategies

January 2016 | Brief


Because only 15 states provide comprehensive dental coverage for adult Medicaid enrollees, there are significant barriers to providing much-needed oral health care for many low-income individuals. This leads to disproportionate rates of oral disease and associated chronic conditions. As the Medicaid population expands through the Affordable Care Act, state Medicaid agencies, health plans, and other stakeholders have the opportunity to enact innovative solutions to address this pervasive issue.

This brief draws on a survey and small group consultation with Medicaid oral health stakeholders and thought-leaders who identified areas of need and promising practices for improving oral health access and outcomes. The Center for Health Care Strategies, through support from the DentaQuest Foundation and the Robert Wood Johnson Foundation, identified five areas ripe for innovation:

  1. The Medicaid oral health business model;
  2. Return on investment models of oral health coverage and care;
  3. Consumer outreach and engagement;
  4. Workforce and training; and
  5. Oral health care access and delivery.

As state Medicaid agencies, policymakers, state coalitions, health and dental plans, and other stakeholders consider strategies for improving the oral health of low-income adults, this brief can inform their efforts in providing new ways to approach delivery system challenges.