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News from the week of AUGUST 12, 2022

• 100 MILLION MOUTHS, OTHER INITIATIVES PUTTING ORAL HEALTH AT FOREFRONT OF PRIMARY CARE (UMass Med) – A new project, 100 Million Mouths, led by UMass Chan’s Medical School seeks to integrate oral health into primary care training programs nationwide.


• MAINE LACKS DENTISTS ACCEPTING MEDICAID IN FACE OF INCREASED DEMAND: 5 NOTES (Becker's), NEW HAMPSIRE NEEDS MORE DENTISTS TO MEET DEMAND WITH ADDED MEDICAID BENEFIT: 5 NOTES (Becker's) – Maine and New Hampshire are struggling to find enough dentists, hygienists and other staff to meet increased demand for dental services after both states expanded Medicaid access to oral health benefits. 


• SENATE PASSES BILL EXTENDING ACA SUBSIDIES, ADDING MEDICARE PRICE NEGOTIATIONS (Healthcare Dive) – The Senate passage of the Inflation Reduction Act, which is expected to also clear the House this week, helps to stabilize the ACA marketplace with an extension of premium subsidies for 13 million Americans.


• HHS: U.S. UNINSURED RATE REACHES RECORD-LOW 8% IN Q1 AMID ACA, MEDICAID GAINS (Fierce Healthcare) – A report from HHS shows that the number of uninsured hit an all-time low in the first quarter primarily due to record ACA enrollment and federal funds for Medicaid. In addition, KFF data shows an increase of 17 million or 23.9% in Medicaid/CHIP enrollment since February 2020.


• 3.7 MILLION PEOPLE WOULD GAIN HEALTH COVERAGE IN 2023 IF THE REMAINING 12 STATES WERE TO EXPAND MEDICAID ELIGIBILITY (Robert Wood Johnson Foundation) – A recent Robert Wood Johnson Foundation report finds that nearly 4 million people would gain health coverage if Medicaid expansion was enacted in the 12 holdout states.


• MACPAC: ONLY 3% GAINED EXCHANGE COVERAGE AFTER LEAVING MEDICAID, CHIP IN 2018 (Fierce Healthcare) – Researchers looking at enrollment data from 2017 through 2019 found that only 3% got ACA coverage within a year after leaving Medicaid/CHIP which suggests there may be issues keeping people covered once the PHE ends and Medicaid rolls are updated. 

News from the week of august 1, 2022

• ECONOMIC OUTLOOK AND EMERGING ISSUES IN DENTISTRY (ADA HPI) – The latest ADA Health Policy Institute economic survey notes patient no shows and cancellations account for most of the unfilled appointments. Staffing issues continue with dental assistants and hygienists remaining difficult to recruit. A new question on benefits revealed that less than half of dentists offer health insurance to their employees, with three in 10 not offering paid leave. Dentist confidence in the overall U.S. economic recovery rebounded slightly last month but remains fairly low.


• NCQA ADDS NEW HEDIS QUALITY MEASURES TO IMPROVE RACE, GENDER HEALTH EQUITY (Health Payer Intelligence) – Changes to NCQA’s HEDIS quality measures include health equity measures, as well as support for better care for pediatric dental services.


• WE COULD FIX RURAL PROBLEMS IF WE WEREN'T BUSY JOKING ABOUT THEM (Penn Live) – The broad stereotypes about economically disadvantaged people lacking teeth contains some truth. Pew and other organizations have documented that low-income rural residents and other groups are more likely to suffer from tooth decay and gum disease and are less likely to see a dentist than urban, white and wealthier people. The author delves into these issues and provides recommendations for improvement.


• THE DENTAL DIVIDE AND THE HEALTH CHASM IT CREATES FOR TOO MANY CHILDREN (Benevis) – A new whitepaper explains how the split between medical and dental care in the U.S. has resulted in health inequities, which contribute to higher instances of disease and other serious health problems, especially for children in low income families. 


• IHME STUDY SHOWS DRAMATIC VARIATION IN HEALTHCARE SPENDING ACROSS U.S. STATES (PR Newswire) – A study from the University of Washington’s IHME looks at variations in factors in health care spending across different states and finds Medicaid expansion had very little impact on increased spending (household income and consumer prices had a much bigger impact on increases) and helped lower spending for children and helped decrease out of pocket spending.

News from the week of July 25, 2022

• SENATE REACHES DEAL TO EXTEND ENHANCED ACA PREMIUMS FOR 3 YEARS AND ON DRUG PRICE REFORM (Fierce Healthcare) – A deal has been reached by Senate leaders to extend ACA subsidies through 2025. If the legislation passes it could help avert huge premium spikes and help preserve coverage for the record-breaking 14.5 million people that signed up for ACA coverage in 2022.


• BLUE CROSS BLUE SHIELD ASSOCIATION ANALYSIS SHOWS PREMIUM COSTS COULD RISE MORE THAN 20% OR EVEN DOUBLE IF CONGRESS DOES NOT EXTEND AFFORDABLE CARE ACT TAX CREDITS (PR Newswire) – BCBSA released an analysis in support of extending ACA premium rebates, showing that failure to extend ACA tax credits could spark big spikes in premium costs and especially impact the nearly 13 million people who receive ACA tax credits. An estimated 5.1 million Americans would be predicted to lose coverage.


• HHS AWARDS NEVADA MEDICAID PROGRAM $1.6M TO CURB DENTAL WORKFORCE SHORTAGE (Becker's Dental) – HHS recently awarded $1.6 million to the Nevada Medicaid program to fund initiatives to help recruit and expand oral health providers in the state.


• ACCESS TO ORAL HEALTH WORKFORCE REPORT (Pennsylvania Coalition for Oral Health) – A report from the Pennsylvania Coalition for Oral Health documents and looks at the impacts of a 10% decrease in oral health workforce participation in the state since 2015. The report also details loss of tax revenue as well as a 13.5% decrease in Medicaid participation while Medicaid enrollment increased 6.6%.


• WANT TO IMPROVE MEMBER RETENTION? GREET THEM THROUGH THE 'DIGITAL FRONT DOOR,' OPTUM SURVEY SAYS (Fierce Healthcare) – An Optum survey found improvements to the digital experience in appointment scheduling, telehealth options, and access to provider data could help with member retention and access to care.


• 50% OF PATIENTS SAY DENTISTS DON'T SCREEN FOR HEALTH RISKS (Dr. Bicuspid) – A recent study asked patients whether their dentists assessed them for risk factors including tobacco use, alcohol use, dietary sugar intake, HIV risk, HPV risk, existing medical conditions during their dental visits. 53% of respondents indicated that they were not asked about any of these conditions during recent dental visits.


• BEING GENERALLY MORE AFFORDABLE THAN MEDICARE, MEDICARE ADVANTAGE ENROLLMENT TO SEE RAPID GROWTH (MedCity News) – A Better Medicare Alliance report predicts that Medicare Advantage enrollment will increase from 45% of the Medicare-eligible population to more than 50% by 2026. In addition, their report finds that individuals with MA plans spend $1,965 less on out of pocket costs and premiums than the general Medicare population. Finally, they cite a 94% satisfaction rate for members enrolled in MA plans.


• 3 TRENDS THAT WILL AFFECT PROVIDERS' FUTURE PROFITS: MCKINSEY (Becker's Hospital Review) – A recent McKinsey report identified factors that will affect provider profits over the next several years including an increase in patient volume due to an aging population resulting in a shift in coverage from commercial to Medicare plans. In addition, the firm estimates that Medicaid enrollment will fall from 25% in 2021 to 22% in 2025 due to benefit redeterminations and some of these people will move from Medicaid to commercial coverage. 


• AMA SURVEY: PATIENTS DO NOT WANT THEIR DATA SOLD (Healthcare Innovation) – A recent AMA survey showed more than 92% stated that personal health data should not be sold and more than 75% said they should be able to opt-in before a company uses their health data.


• AMAZON WILL SEE YOU NOW: READING BETWEEN THE LINES OF THE ONE MEDICAL ACQUISITION (Healthcare Dive) – Amazon’s recent deal to acquire primary care network One Medical helps Amazon fast track entry into the employer market and provide One Medical with stability and cushion of cash.

News from the week of july 18, 2022

• CONSUMERS WANT A MORE CONNECTED, PERSONAL HEALTHCARE EXPERIENCE, NEW CVS STUDY REVEALS (CVS Health) – A new survey reveals that patients are seeking a more holistic healthcare approach and convenience, accessibility and cost are key factors shaping the experience.


• INFLATION DRIVES COST OF DENTAL SERVICES UP 1.9% IN JUNE: 3 NOTES (Becker's Dental) – As costs rise, dentists and foundations are working with patients to help manage affordability.


• RISING DENTAL COSTS IMPACTING PATIENTS, DENTISTS (NBC CT) – As costs for dentists and patients rise, providers and foundations are working to help manage affordability.


• ACA MARKETPLACE PREMIUMS POISED TO JUMP (Healthcare Dive) – A new analysis from the Kaiser Family Foundation. The 72 insurers KFF reviewed are targeting a 10% median rate boost in 2023 due to inflation and the end of ACA subsidies


• MEDICAID'S NEW OPTION TO EXTEND POSTPARTUM COVERAGE FOR 12 MONTHS COULD PREVENT HUNDREDS OF THOUSANDS OF ENROLLEES FROM LOSING COVERAGE IN THE MONTHS AFTER DELIVERY, KFF ANALYSIS FINDS (Sierra Sun Times) – A new KFF analysis finds that more than 600,000 postpartum women were disenrolled from Medicaid in 2018 within a year of giving birth. A new federally funded option to extend postpartum care has already been adopted by 33 states.


• MEDICARE'S PROPOSED PAYMENT RULE OFFERS CRITICAL "CLARIFICATION" AND POSSIBLE EXPANSION OF MEDICALLY NECESSARY DENTAL COVERAGE (Medicare Rights Center) – Reactions are coming in regarding CMS’s proposal to increase and expand the scope of Medicare dental reimbursements. The Medicare Rights Center welcomes the change as an interim step to full coverage, and dentists interviewed by Becker’s had mixed reactions.


• WHAT THE POTS SHUTDOWN WILL MEAN FOR FAXING IN THE HEALTHCARE INDUSTRY (Healthcare Dive) – The end of the archaic and costly POTS (plain old telephone service) infrastructure on August 2, 2022 may cause issues for providers that still rely on this technology for paper fax machines. 


• HHS RENEWS COVID-19 PUBLIC HEALTH EMERGENCY ANOTHER THREE MONTHS (Fierce Healthcare) – HHS Secretary Xavier Becerra has extended the Public Health Emergency for another 90 days. The agency has also offered guidance for state Medicaid agencies to prepare for the transition.


• SKYGEN EARNS URAC ACCREDITATION (Dentistry Today) – SKYGEN is proud to announce it has earned URAC accreditation for Health Utilization Management.

News from the week of July 11, 2022

• RAISING THE BAR: HEALTHCARE CAN HELP MAKE EQUITY A REALITY (Robert Wood Johnson Foundation) – The Robert Wood Johnson Foundation has developed a framework for the healthcare sector, focused on embedding equity to help raise levels of health for all. 


• INFLATION COULD CUT HEALTHCARE SECTOR PROFITS BY $70B OR MORE THIS YEAR (Medical Economics) – A McKinsey report proposes that providers and health systems focus on operational excellence and resilience to succeed during this period of high inflation and staffing shortages.


• BROOKINGS: A LOOK AT PROFITABILITY IN MEDICARE ADVANTAGE (Fierce Healthcare) – A Brookings study of Medicare Advantage plans finds the biggest profits are seen by the top five plans that can benefit from spending on internal businesses that are not subject to medical loss ratios. Spending on these related businesses can range from 20 to 71% of total spend.


• ADA, STAKEHOLDERS SUPPORT MEDICAID DENTAL BENEFITS ACT (ADA) – The ADA and other groups recently urged lawmakers to support the Medicaid Dental Benefit Act of 2021, which would require comprehensive dental care Medicaid coverage a requirement in all states.


• DENTAL GROUPS URGE CMS TO EXPAND DENTAL SURGERY ACCESS (Becker's Dental) – Dental groups are urging CMS to expand access to surgical dental services for children and adults with special needs and disabilities, recent news items have mentioned extremely long waits for service.


• CMS PROPOSES COVERING DENTAL SERVICES FOR MEDICARE RECIPIENTS (Dr. Bicuspid) – CMS has released a new Medicare provider fee schedule which would include dental coverage.


• URBAN INSTITUTE: NUMBER OF UNINSURED CHILDREN FELL DURING COVID-19, BUT PROGRESS COULD STALL WHEN PANDEMIC PROTECTIONS EXPIRE (Fierce Healthcare) – The number of uninsured children rose in 2021, meaning roughly 700,000 additional children gained coverage.


• SPECIAL ISSUE: ANTIRACISM IN DENTAL PUBLIC HEALTH: ENGAGING SCIENCE, EDUCATION, POLICY, AND PRACTICE (Journal of Public Health Dentistry) – A special issue of the Journal of Public Health Dentistry focuses exclusively on anti-racist solutions in public health dentistry. Articles look at issues and solutions around discrimination and racism in dental public health.


• ADA HIGHLIGHTS STATE ADVOCACY WINS TO IMPROVE DENTAL MEDICAID (ADA) – As state legislatures wrap up their business, the ADA takes a look at gains in Medicaid dental coverage. Budget surpluses have prompted at least 14 states to expand benefits or reimbursements in their Medicaid dental programs and three other states have pending legislation.


• MEDICAID FINANCIAL ELIGIBILITY IN PATHWAYS BASED ON OLD AGE OR DIABILITY IN 2022: FINDINGS FROM A 50-STATE SURVEY (KFF) – KFF presents an in-depth state-level survey of Medicaid financial eligibility through old age or disability methods which tend to present much more variation than the Modified Adjust Gross Income (MAGI) criteria.

News from the week of June 20, 2022

• ECONOMIC OUTLOOK AND EMERGING ISSUES IN DENTISTRY (ADA HPI) – The latest ADA Health Policy Institute economic survey shows not much change from previous months with schedules 86% full and staffing issues persisting. Dentist confidence in the overall US economic recovery continues to drop.


• STATE OF ORAL HEALTH EQUITY IN AMERICA 2022 (CareQuest) – CareQuest’s annual oral health equity report finds that more than half of adults reported some type of oral health problem, with many not seeking care due to cost. 


• HEALTHCARE DEBT IN THE U.S.: THE BROAD CONSEQUENCES OF MEDICAL AND DENTAL BILLS (KFF) – This in-depth report looks at the far-reaching implications of health care debt including forced sacrifices in other areas and ability to access care. Four in 10 Americans are estimated to hold medical or dental debt. In addition, 49% of those holding medical debt cite dental care as the top source of debt (particularly among Medicare-aged adults who lack coverage)


• MEDICARE DATA ERRORS IMPEDE HEALTH EQUITY EFFORTS, OIG SAYS (Healthcare Dive) – A new report finds inaccuracies in Medicare enrollment data limit the ability to address health equity.


• AMONG FIRST-YEAR DENTAL STUDENTS, WOMEN SEE THE HIGHEST RATE OF ENROLLMENT (ADA HPI) – The ADA finds enrollment increases among Black, Hispanic and female dental students in 2021.


• CMS EXPANDS MEDICAID POSTPARTUM COVERAGE IN 3 STATES, DISTRICT OF COLUMBIA (Fierce Healthcare) – Fourteen states and DC have had their proposals to expand Medicaid postpartum coverage approved.


• VIRGINIA BOOSTS MEDICAID REIMBURSEMENTS FOR DENTAL PROCEDURES: 5 THINGS TO KNOW (Becker's Dental) – Virginia recently passed a budget that will help bridge dental reimbursement gaps as rates haven’t changed since 2005.

News from the week of June 13, 2022

• TWO-THIRDS OF OLDER AMERICANS SEE HEALTHCARE COSTS AS A FINANCIAL BURDEN (The Hill) – A new West Health-Gallup survey finds 37% of US adults over 65 are extremely concerned or concerned they won’t be able to pay for necessary health care over the next year while 45% of adults in the 50-64 age group share this concern. In addition, more than 1 in 3 adults 50+ have forgone basics such as food to pay for healthcare


• HEALTHCARE HITS RESET (Philips) – A new report from Philips shows health system leaders are shifting to address staffing challenges, close the health equity gap and expand digital transformation in the sector.


• AMA ENDORSES POLICIES TO PREVENT LOSSES AFTER THE PUBLIC HEALTH EMERGENCY (AMA) – The AMA has put out a list of recommendations to help states prevent coverage losses after the end of the public health emergency including streamlining enrollment and renewal and investing in outreach and enrollment assistance.


• 5 WAYS TELEDENTISTRY CAN IMPROVE THE ORAL HEALTH SYSTEM (Dental Economics) – A recent CareQuest report on teledentistry revealed ways in which the practice may improve access to quality care and lower costs.


• NEW ADA GUIDE CREATED FOR ENSURING ACCURACY OF CLAIMS MADE ON BEHALF OF TREATING DENTISTS (ADA) – The ADA has published a guide outlining the role of the treating dentist in claim submissions.


• SHOULD NORTH CAROLINA OPERATE ITS MEDICAID ORAL HEALTH PROGRAM AS FEE-FOR-SERVICE OR TRANSITION TO MANAGED CARE? (North Carolina Health News) – A new North Carolina task force will survey providers and other states to determine whether their Medicaid oral health program should remain fee for service or move to a managed care model when contracts are renegotiated in 2024.


• MEDICARE ADVANTAGE PLANS HAVE GREAT PROMISE BUT THEY ARE NOT DELIVERING (Forbes) – Forbes takes a critical look at Medicare Advantage plans and determines they are neither cutting costs nor delivering better care than traditional Medicare.

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  News from the week of June 6, 2022

• ECONOMIC OUTLOOK AND EMERGING ISSUES IN DENTISTRY (ADA HPI) – The ADA’s May economic survey shows continued recruitment issues, particularly for hygienists, while dentist’s confidence in the broader economy continues to drop.


• HEALTHCARE PAYROLLS RECOVERING, STILL LAG PRE-PANDEMIC LEVELS (Healthcare Dive) – A recent Bureau of Labor Statistics report shows slow steady gains in employment in the healthcare sector, including an increase of 1,000 workers added by dental offices in May.


• IT'S TIME TO START INNOVATING TO MAKE ADMINISTRATIVE DATA INTEROPERABLE (MedCity News) – This article looks at how payers and providers could free up resources by cutting billing and insurance administrative costs through improved interoperability.


• SMILEDIRECTCLUB, ALIGN TECHNOLOGY RANKED AMONG FASTEST-GROWING COMPANIES (Becker's Dental) – Two dental sector businesses made it on the Financial Times list of fastest growing companies.


• ORAL HEALTH INEQUALITY IMPACTS JOB OPPORTUNITIES, IF YOUR MOUTH COULD TALK PROVIDES SOLUTION AS U.S. HEADS BACK TO WORK (Business Wire) – A new bestselling book provides a roadmap for reducing the oral health care gap that keep many Americans from achieving personal and financial success.


• MANY CHILDREN AREN'T GETTING THE VISION SCREENING THEY NEED (Washington Post) – Vision screenings for children, critical for early detection of eye issues, declined even further during the pandemic.


• 4 WAYS ADMINISTRATION TECHNOLOGY CAN IMPROVE DENTAL PRACTICE MANAGEMENT (Healthcare Business Today) – In this article, SKYGEN’s COO – TPA Business, Kyle Koltz shares how dental practices can use technology to address consumerism, create more time for patient care, reduce manual tasks, and improve efficiency and profitability.

News from the week of May 30, 2022

• HEALTHCARE SPENDING COULD DROP $11.4B NEXT YEAR IF PREMIUM SUBSIDIES EXPIRE, RESEARCH FINDS (Healthcare Dive) – A recent report by the Urban Institute and Robert Wood Johnson Foundation finds that the expiration of credits for ACA plans could leave more than 3 million people without coverage and  cause a drop of more than $11B in health spending next year. 


• TOP 10 DSOs: THE LARGEST KEEP GROWING (Dr. Bicuspid) – The ADA HPI’s monthly survey of dentists found 2/3 of dentists require patients to wear a mask in the waiting area. Patient schedules were 88% full in March up from 83% in February and 77% in January. Fewer than 3 in 10 dentists are confident in the US economic recovery although a majority are somewhat confident in their practice’s and the dental sector’s recovery.


• JD POWER: HEALTH PLANS HAVE WORK TO DO IN COMMUNICATING WITH MEMBERS (Fierce Healthcare) – A JD Power report finds health plans are coming up short in delivering effective member experiences and only 22% rate their health plans as innovative.


• SENIORS EXPECTING MORE FROM THEIR MEDICARE PLANS THAN JUST BASIC CARE (Medical Economics) – A Virgin Pulse survey of older Americans finds they expect personalized communication and robust supplemental benefits as part of their Medicare Advantage plans.


• DIABETES MAY WEAKEN TEETH AND PROMOTE TOOTH DECAY (Science Daily) – Researchers at Rutgers found “reduced strength and durability of enamel and dentin” among diabetics may explain why they are susceptible to tooth decay.