Recorded presentation

Howard L. Bailit, DMD, PHD¹, Tryfon R. Beazoglou, PhD², Dennis V. Heffley, PhD³, and Monica K Lopez, MS³. (1) Community Medicine and Health Care, University of Connecticut, 263 Farmington Avenue, Farmington, CT 06030, 860-679-5487, bailit@nso1.uchc.edu, (2) Pediatric Dentistry, University of Connecticut, 263 Farmington Avenue, Farmington, CT 06030, (3) Economics, University of Connecticut, 341 Mansfield Road, Storrs, CT 06269

This paper examines the financial feasibility of a new dental delivery model for Medicaid and S-CHIP eligible children in Connecticut. In this model, a company (for-profit or not-for-profit) employs hygienists and ancillary staff to provide screening and preventive services to children in schools, Head Start programs, summer camps etc. using portable equipment. The revenues generated by hygienists cover the cost of the hygiene services, the transportation of children with treatable oral diseases to the offices of private and safety net dentists, and supplemental fees (in addition to usual Medicaid charges) to dentists to bring their total billings/child to competitive hourly rates. The financial feasibility of the model was tested with data from 5 Connecticut communities. Based on 16,020 eligible children from 69 schools (K-12) and using existing Medicaid fees, the model is financially feasible if hygienists treat 14 patients per day and over three years, the system generates a modest surplus. The major advantages of the proposed program are: 1) most Medicaid/SCHIP eligible children receive appropriate care; 2) the incidence of decay is reduced; 3) relatively few dentists are needed to provide treatment services; 4) no legislative/regulatory changes in the Connecticut Dental Practice Act or the Medicaid program are required; and 5) several communities, schools, and organized dentistry are supportive. The State is in the process of contracting with the private insurance company that will be responsible for administering the dental Medicaid program to pilot test the model delivery system.

Learning Objectives:

• Identify 5 program features that drive the financial model
• Determine the political position of 4 important stakeholder organizations in the new system
• Assess several advantages and disadvantages of the model system

Keywords: School-Based Health Care, Oral Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation