198285 Framing the case for oral care: Translating resarch to policy with a combined claims data set for return-on-investment (ROI) analyses in Maine

Sunday, November 8, 2009

Kala E. Ladenheim, PhD, MSPH , Medical Care Development, Augusta, ME
Margaret I. Gradie, PhD , Medical Care Development, Augusta, ME
Kathleen E. Perkins, MPA , Director, Division of Health Improvement, Medical Care Development, Augusta, ME
The Maine Oral Return-on-investment (ROI) project develops and tests analytic tools and policy methods to advance adult access to oral health services as a means of reducing the overall cost of health care. We created a Maine-specific database linking dental and medical claims; engaged stakeholders to define key elements and assumptions in a consensus approach to estimating ROI; and demonstrated the method by using it to estimate impacts of oral health services in Maine for two groups: pregnant women and people with diabetes. The ROI estimates may be used to make the economic case for improved oral health services and inform and promote policy changes with both public and private insurers.

This session uses economic analysis to translate research into policy terms. A tool to support oral health policy is created using ROI to frame research findings related to the impact of periodontal care on medical outcomes. The project builds buy-in among policy-makers by engaging them in definitions of populations, procedures and outcomes used in the analysis. Maine-specific data consisting of combined dental and medical claims allow us to replicate other studies and adjust results to Maine's population. In addition to clinical investment and returns, social returns are estimated. Recent studies related to the impact of periodontal health and control of diabetes, birth outcomes, and other conditions mediated by inflammatory processes undergird the analysis. Controversy over the nature and strength of causality is expressed through sensitivity analysis and a range of possible values.

Learning Objectives:
Design an economic analysis to present research findings in a policy framework. Assess the relevance of studies that show an association between oral conditions and medical outcomes. Identify opportunities for and limitations in combining contextual and claims data.

Keywords: Oral Health Outcomes, Economic Analysis

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am conducting the project that is being reported on at this session. I have previously presented a number of programs as staff at NCSL and taught at the graduate level at the George Washington University on policy analysis and framing research for policy makers.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Policies to Improve Oral Health
See more of: Oral Health