New IOM Report Confirms CT Health’s Direction in Oral Health

July 19, 2011

Last week the Institute of Medicine (IOM) and the National Research Council released their report, “Improving Access to Oral Health Care for Vulnerable and Underserved Populations”.  The full report is 242 pages – but the brief that’s linked to is 4 pages. It’s worth reading.

We’re encouraged to see this issue raised again at a national level. At the Connecticut Health Foundation, we’re well aware of the consequences of poor oral health, and how these disproportionately affect children, people of color and other underserved populations. In 2010, we made improving the oral health of pregnant women and children ages 0-5 from low-income families our priority (if you’re interested, here’s our full strategic plan).

The report calls for an oral health care system that will:

  • Eliminate barriers that contribute to oral health disparities;
  • Prioritize disease prevention and health promotion;
  • Provide oral health services in a variety of settings;
  • Rely on a diverse and expanded array of pro­viders who are competent, compensated, and authorized to provide evidence-based care;
  • Include collaborative and multidisciplinary teams working across the health care sys­tem; and
  • Foster continuous improvement and inno­vation.

The next logical question is, how do we get there from here? We’ve pulled out 3 of the 10 recommendations from the report that we’re actively working on already.

1: Integration

The report discusses integrating oral health care into overall health through working with a variety of health care workers – including those outside the dental field.

We agree that providers across the health care spectrum have a role to play in oral health. That’s why we support the integration of oral health into the health care, human services and education systems for children from low-income families. We discuss some of the “why’s” of that here, but in short, we believe a multi-pronged approach will increase the likelihood of reaching these children.

2: Research

Integration on its own is unfortunately not enough. The IOM report calls for more research – and specifically charges foundations “to support oral health research and evaluation of new methods to provide care for vulnerable and underserved.”

We’re currently in partnership with the University of Connecticut to better understand how best to engage pregnant women in prioritizing their oral health. The research includes optimal health promotion practices and focus groups to better understand why or why not low-income pregnant women access care.

3: Reducing barriers

Like other reports on challenges to access to oral health care, the IOM report cites financial and administrative barriers as being key challenges to access, and calls for the reduction of these barriers.

The key to understanding these barriers is to recognize that underserved populations typically receive coverage for oral health care services from publicly funded programs, e.g. Medicaid. How Medicaid is structured and funded dictates how easily members can receive these services and have them paid for.

As a state, Connecticut has made huge strides in this area, both in raising the Medicaid reimbursement rate and in implementing the revised Medicaid dental program, the Connecticut Dental Health Partnership.  Preliminary data shows that this has significantly increased provider participation and the number of children receiving care on the Medicaid program.

We’re looking forward to continuing our work on this critical issue. As usual, we want to hear from you. What did you think of the IOM report? Do you think they left anything out? What would you like us to know as we’re thinking about the findings in this report?

Later this week, we’ll be featuring a post regarding research that we’ve funded to assess the impact of raising Medicaid reimbursement rates on oral health care access. Please check back in!

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