Opinion: Insurance coverage is misaligned with dental science
Andja Demiraj, a dental student at Yale University, stressed that adult dental Medicaid coverage could be lacking in Connecticut and elsewhere across the United States.
In a commentary published in the CT Mirror, Ms. Demiraj argued that despite recent research demonstrating the potential connections between oral health and overall health, oral healthcare has been kept separate from the rest of healthcare and, unlike required dental coverage for children in the Medicaid program, a dental benefit for adult enrollees continues to be optional. The divide in healthcare has led to worse oral health disparities among underserved patient populations.
She emphasized that emergency department visits for avoidable dental issues — which are cost ineffective for the patients and the healthcare system and may result in poorer outcomes — are common and could stem from limited or no access to regular dental care. When patients avoid treatment for dental caries, the decay can progress into emergency infections that carry treatment costs far exceeding regular dental visits. For instance, dental-related emergency department visits cost nearly $2.5 billion annually, but patients may only receive treatments offering temporary relief, such as antibiotics or analgesics, without addressing the underlying disease, according to Ms. Demiraj.
Medicaid programs in Connecticut currently exclude coverage for preventive and restorative dental treatment among low-income adult beneficiaries, creating disparities in access to necessary dental care, higher rates of untreated periodontal disease and greater risks of systemic comorbidities that have been linked to poor oral health — such as cardiovascular disease, diabetes and Alzheimer’s disease.
Ms. Demiraj urged policymakers to expand Medicaid dental coverage to include preventive care for adults in order to identify and treat dental issues at earlier stages, when treatment is simpler and more affordable. This kind of care could also lift the burden off emergency departments and alleviate the healthcare system of the costs of dental emergencies. In addition, increasing the Medicaid reimbursement rates for dental care as well as introducing other incentives could encourage more dental professionals to participate in Medicaid programs, while employing a phased implementation approach to expanded coverage could help dentists prioritize more basic care among high-risk patient communities.
“[A]ddressing years of unmet need will require investment. However, focusing only on short-term spending misses the larger reality. Preventive care reduces long-term costs by avoiding expensive hospital visits and advanced treatments,” Ms. Demiraj underscored.
“Connecticut has the opportunity to take a more efficient and equitable path forward,” she concluded.
Read more: CT Mirror
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