Funder: Washington Dental Service Foundation

June 22, 2016 | Webinar

As state Medicaid programs move toward value-based payment, states interested in improving adult oral health care access and outcomes are testing creative strategies to integrate dental care into primary care delivery. For example, through State Innovation Model (SIM) grants from the federal Center for Medicare and Medicaid Innovation, many states have explored oral health integration in statewide delivery system and payment reform efforts. States without SIM grants are also identifying ways to incorporate dental services into primary care models.

This webinar, made by possible by the Washington Dental Service Foundation, explored the range of approaches to oral health integration that states are considering in the areas of: (1) Medicaid benefit design and expansion; (2) practice-level oral health reforms; and (3) statewide delivery reform models. It drew from a recent CHCS brief, Oral Health Integration in Statewide Delivery System and Payment Reform, and features innovations from two states, including the development of primary care integration models in Virginia and the incorporation of oral health into Oregon’s coordinated care organizations.


I. Introduction: Impetus and Opportunities for Oral Health Integration

 Speaker: Stacey Chazin, Director of Prevention Programs, Center for Health Care Strategies

Ms. Chazin discussed the opportunities that the federal SIM program has presented for states to consider integrating oral health in new payment and delivery models, as well as various approaches that states within and beyond SIM have pursued. She provided an overview of key opportunities for innovative oral health integration in Medicaid benefit design and expansion; practice-level oral health reforms; and statewide delivery reform.

II. Virginia: Models for Oral Health Integration in Care Delivery

Speaker: Sarah Bedard Holland, Executive Director, Virginia Oral Health Coalition, and Co-Chair, Oral Health Integration Workgroup, Virginia SIM Initiative

Ms. Holland discussed how Virginia used a SIM design grant to develop five models for consideration by accountable care communities to integrate oral health in: pediatric care, maternal health, chronic disease care, emergency department diversion, and care for adults with serious mental illness. She shared an oral health integration toolkit that the Virginia Oral Health Coalition produced, as well as highlights challenges and approaches to advancing the inclusion of oral health in statewide health care metrics and Delivery System Reform Incentive Payment (DSRIP) waivers.

III. Oregon: Incorporating Oral Health in Coordinated Care Organizations

Speakers: Lisa Krois, SIM Project Director, and Bruce Austin, DMD, Dental Director, Oregon Health Authority

Ms. Krois and Dr. Austin discussed how Oregon, which has a SIM testing grant, uses regional Medicaid accountable care organizations — called coordinated care organizations (CCOs) — to work with local dental care organizations to provide oral health care services to Medicaid beneficiaries. They described the innovative payment model supporting those services; the role of oral health metrics in the CCO model; and future plans for oral health integration. Challenges in implementing these approaches were also shared.