A nonprofit dental organization plans to push forward with a pilot program to improve dental care for pregnant women and diabetic patients on low-income state health insurance despite the possibility that it won’t get state support.
The Washington Dental Services Foundation (WDSF) wants to enroll almost 7,000 pregnant women and diabetic Medicaid patients in Whatcom and Thurston counties in an enhanced dental care program to see if better oral health leads to lower medical costs.
Other studies have found such a connection, but that research focused on patients with commercial dental insurance, according to the Washington State Health Care Authority, the body that purchases health insurance for low-income patients and public employees.
In 2014, researchers from the University of Pennsylvania, Highmark and insurer United Concordia found that pregnant patients and those with type 2 diabetes, stroke and heart disease who got treatment for gum disease racked up fewer medical bills and hospitalizations than those without. That study, the largest of its kind, included 300,000 people.
“Commercial insurers out there that have seen this and are tailoring their benefits based on this evidence,” said Diane Oakes, president and CEO of WDSF. “Really what we’re trying to do is say to the state, ‘Don’t miss out.’”
However, recent drafts of the state budget haven’t included funding for the program, Oakes said.
The study needs money from the state to increase Medicaid payments to dentists. Washington pays dentists less than all but three other states in the nation. Dentists receive a little less than 29 percent of what they would have gotten from a patient with commercial insurance in 2014, according to the American Dental Association.
That 70 percentage-point gap makes it hard for patients to get dental care, even if they have insurance. That’s a big deal: Roughly 1.86 million people were enrolled in Apple Health, the state-run Medicaid plan, as of January, according to the Health Care Authority.
The pilot program focuses on pregnant women and diabetic patients because they tend to be more susceptible to gum disease and have worse outcomes.
Research has found a two-way relationship between diabetes and gum disease where each exacerbates the other. New mothers stand a much higher chance of passing disease-causing bacteria to their new children, raising the possibility of tooth or gum disease, Oakes said.
Beyond that, enrollment in Medicaid means that these patients will see doctors who can refer them to the program. One of WDSF’s projects involves training doctors to recognize the warning signs of oral diseases so that patients can get the referrals they need.
If the program doesn’t get state funding, WDSF plans to go ahead with efforts to identify and refer patients to strengthen a future proposal, Oakes said.
“This is an example of an innovation that we can really be working toward that state can invest in. The dental program through Medicaid is underfunded, under-resourced and understaffed,” Oakes said.