Medicaid: Creating bright smiles and bright futures

By the CDHP team

This guest blog post was written by Justin M. Senior, Deputy Secretary for Medicaid in Florida’s Agency for Health Care Administration (AHCA). We’re pleased the agency is participating in this week’s Blog Carnival in which various stakeholders discuss the oral health safety net that Medicaid and CHIP provide.

Forty years ago, President Lyndon B. Johnson pushed to expand the Medicaid program to focus on children’s health. At the time, he was championing an idea that every parent knows today — when it comes to children’s health, the early years are crucial.

We have made a lot of progress since then. More children are covered today than ever before, but that does not mean every child in America has the same chance at a healthy future. Children from low-income families are more likely to have problems affecting their behavioral development, vision, hearing, and oral health — all situations that can affect how children learn, play and grow. To combat these disadvantages, we must continue to find innovative ways to get these children the routine, preventative services they need to remain healthy. 

According to the 2011-2012 National Health and Nutrition Examination Survey, approximately 23% of children aged 2-5 years and 60% of adolescents between 12 and 19 years had tooth decay. Problems like these are entirely preventable with proper diet, oral hygiene and access to dental care. Because getting a good healthy start in life is so important, in Florida we are taking steps to improve these outcomes for children enrolled in the Medicaid program.  

Our priority is to make sure children are seen by trusted medical professionals early and often.

As part of our State Oral Health Action Plan, AHCA has set a goal of increasing preventive dental service utilization for Medicaid recipients aged 1-20 by 10 percentage points by the end of this year. To help us reach this goal, we have teamed up with health plans participating in the Florida Medicaid program to develop Performance Improvement Projects (PIPs). These PIPs will assist in identifying barriers that are preventing children enrolled in their plan from receiving proper dental care. Once these barriers are identified, plans can develop and implement interventions aimed at removing the barriers.

The principle behind the State Oral Health Action Plan is simple: children need to get the right services at the right time and in the right settings. Otherwise, small problems can become large ones. With the information gained from the PIPs, our priority is to make sure children are seen by trusted medical professionals early and often. If these health care professionals find a problem, health plans cover the diagnosis and treatment services that are needed to correct or remediate the problem. Getting out in front of the issue can help save a child years of pain, distracted learning, and torment.   

The best part of all of this? We’re already seeing results. We saw improved dental access every year in Broward and Duval counties in a health plan pilot that ran from 2006 to 2013 as measured by nationally-recognized Health Effectiveness Data and Information Set (HEDIS) scores. Now that the health plan model has been implemented statewide, we expect to see similar improvements on a larger scale, and that will help the children of Florida have bright smiles and bright futures.     

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children ages 6-12 suffered a toothache in the previous six months.
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