State Spotlight: Illinois Adopts a Culture of Prevention and Early Action
Prevention is key. That is the mantra of oral health advocates across the state working tirelessly to improve oral health outcomes of all Illinoisans despite budget constraints and the administration’s competing priorities.
However, in just a few months since we last checked in on the oral health status of Illinois in A State of Decay, Vol. IV, the state has successfully pushed forth its prevention-centered, early treatment agenda by enhancing adult Medicaid dental benefits and approving reimbursement rates for the application of Silver Diamine Fluoride (SDF) on children, adults and older adults.
The road to including procedures and services for the prevention and treatment of periodontal disease in Medicaid, was long. According to Greg Johnson, Executive Director of the Illinois State Dental Society (ISDS), years of coalition building and advocacy propelled this benefit language to be included and approved in the FY 2019 budget. Before the legislature approved the FY19 budget and included language to extend preventive dental services to half a million Medicaid enrollees, some Managed Care Organizations (MCOs) across the state were already offering some level of preventive dental services to the nearly 1.7 million enrollees.
According to Mona Van Kanegan, DDS, MS, MPH, Oral Health Director at Illinois Department of Public Health, “Many states, like Illinois, are transitioning to managed care plans in Medicaid. In Illinois, some managed care plans had added a preventive dental visit in the form of a dental cleaning as incentive for patients to sign up for their medical plan. But the preventive benefit was optional and not all plans provided prevention services for adults. With this improvement, there will be consistency in the basic level of coverage of adult preventive services.”
This was an important jumping off point in advocating for Medicaid dental coverage because it justified the overall health benefits and cost savings that come with publicly funded adult dental coverage.
ISDS and invested oral health stakeholders across Illinois have long advocated for preventive measures they believe will curb costly dental services down the road. ISDS has activated its dentists, offered testimony on behalf of a preventive benefit during Medicaid hearings, engaged representatives and all five leaders in the State Legislature and Executive branches, and advocated for increasing the auxiliaries of dental professionals across the state.
Dr. Barbara Mousel, president of the Illinois State Dental Society (ISDS), stated, “The addition of preventive dental services for all adults is critical in improving oral health for these Illinois citizens. It gives dentists the opportunity to provide early interventions for not only dental disease but overall health as well. Diabetes, heart disease, and other systemic diseases are often better managed when oral health is maintained. I congratulate the legislators and Governor Rauner for supporting these long-needed changes.”
Another expansion of benefits in the Illinois Medicaid program is the reimbursement for Silver Diamine Fluoride, an interim caries arresting service. A clinically applied liquid, this treatment reduces dentin hypersensitivity and allows oral health care professionals to arrest dental caries with a noninvasive, painless, and quick method across the age spectrum. This an important development in Illinois Medicaid as many groups can benefit from this intervention including the very young, individuals with disabilities or special health care needs, the elderly, and others with inconsistent access to dental treatment services.
Adding adult prevention, periodontal benefit and interim caries arresting services makes the Illinois Medicaid program more useful for people who disproportionally suffer from these dental diseases.
The work is not over however. A critical next step will be to increase the number of providers in the system who can offer these services so that people who need these services can receive them. According to ISDS, only 2,800 of the state’s approximately 9,000 regularly practicing dentists accept patients in the Medicaid program.
Further, it has been seven years since a Basic Screening Survey (BSS) was conducted to study the older adult population. Following an updated BSS, the state may be equipped to create a new State Oral Health Plan to include SMART objectives for older adults.
But, by promoting a culture of preventive and timely access to oral health care services, Illinois is set to improve the overall health and wellness of its child, adult and aging population.