In a laudable move, two local health insurers are putting their money where their mouth is — or more precisely, their patients’ mouths via better dental health.
AlohaCare and Ohana Health Plan are investing nearly $1 million to provide free basic dental care for its adults on Medicaid: to cover teeth-cleaning every six months, an annual exam, simple tooth extraction or filling, and topical fluoride. It’s a worthy, humane attempt to provide dental care to at-risk populations, in hopes of preventing more-serious and costly work later, with overall community benefits.
“Oral health is critical to good health and overall well-being,” said Scott Sivik, Ohana Health Plan state president. “The mouth is the gateway to the rest of the body and provides clues about overall health and larger health issues such as diabetes, heart disease and cancer.”
The health-care industry in recent years has been a minefield of escalating costs, doctor shortages, technological mandates, and unstable insurance and regulatory environments — which makes this move to cover basic dental care welcome and encouraging. Enrollment via the state is underway this month for coverage that starts
Jan 1. Though this launch would initially affect a relatively small pool of patients — AlohaCare and Ohana Health Plan have 34,000 and 22,000 adult Medicaid members, respectively — it does have potential to spread among the 364,000 Hawaii residents covered by Medicaid, the government health insurance program for low-income and disabled residents.
The long-range health benefits and cost-savings from today’s investment in basic dental coverage should spur on other insurers with Medicaid beneficiaries — Hawaii Medical Service Association, Kaiser Permanente and UnitedHealthcare — to do likewise.
Setting aside the humanitarian health aspect, the cost-benefit equation looks compelling. A study published last month in the Journal of the American Dental Association analyzed data of Medicaid adults from 2000-2015, and found that offering basic dental benefits did result in higher use of preventive and other types of dental services, and lowered out-of-pocket share of dental costs. Those out-of-pocket costs were about 19 percentage points lower among enrollees in basic-dental-coverage states than in uncovered states.
Due to budget cuts, the state of Hawaii in 2009 eliminated funding for non-emergency adult Medicaid dental services. It seems more than coincidence, then, that the emergency-room visits for oral-health problems increased between 2007 and 2016, as Hawaii Health Information Corp. stats show. And as is often emphasized, hospital emergency-room care is exponentially more expensive than a routine doctor, or dentist, office visit.
Cost is a big consideration, of course, but so, too, should be preventative care. Dental health can often be perceived as a lower-level need, lacking the imperative of traumatic injuries or severe diagnoses such as cancer or heart disease. But neglecting oral hygiene can lead to health deterioration — mouth bacteria can lead to heart and other diseases, for instance — a painful and expensive path that could be averted by early detection of issues.
“We have too many patients come in and have a crack in their tooth or a tiny cavity that blossoms and becomes pervasive in terms of decay and periodontal disease,” said Sheila Beckham, CEO of the Waikiki Health Center, which provides dental and medical services to some 5,000 Medicaid patients yearly, many of them homeless, many with HIV.
An ounce of prevention is worth a pound of care — that’s a truism that applies to every aspect of health and well-being, not least of which is dental health. Thanks to AlohaCare and Ohana Health Plan, some 56,000 people stand to benefit soon from a forward-thinking strategy — one that’s worth investment and pursuing by other insurers.
