FLORIDA’S STATE ORAL HEALTH ACTION PLAN February 2015 Bureau of Medicaid Services Presented by: Bob Reifinger

FLORIDA’S STATE ORAL HEALTH ACTION PLAN Presentation Objectives At the end of the presentation participants will be able to answer: What progress is FL making in regards to Medicaid or CHIP eligible children, age 1 through age 20 years, who receive a preventive dental service? Where is FL ranked nationally regarding Medicaid or CHIP eligible children, age 6 through age 9 years, who receive a dental sealant on a permanent molar tooth? What is the Florida ‘State Oral Health Action Plan’ and how will it impact the Florida Medicaid oral health program? FLORIDA’S STATE ORAL HEALTH ACTION PLAN

FLORIDA’S STATE ORAL HEALTH ACTION PLAN Where does Florida rank nationally?

FLORIDA’S STATE ORAL HEALTH ACTION PLAN FL’s baseline was 18% in 2012 and looking to be at 28% in 2015. We have a good start.

FLORIDA’S STATE ORAL HEALTH ACTION PLAN FL is at the bottom of the list when it comes to getting sealants on Medicaid eligible children, ages 6-9.

FLORIDA’S STATE ORAL HEALTH ACTION PLAN Oral Health Initiative The Centers for Medicare & Medicaid Services (CMS) selected a total of five states in the fall of 2014 to participate in a learning collaborative to provide state Medicaid agencies with technical assistance to design, develop and implement a State Oral Health Action Plan (SOHAP) District of Columbia, Kansas, Michigan, Utah and Florida Initial collaborative period October 27, 2014 - May 15, 2015 FLORIDA’S STATE ORAL HEALTH ACTION PLAN http://www.civilengineeringjobs.com/statelist.shtml

SOHAP Goals Aimed at meeting CMS’ children’s oral health care improvement goals: - Increasing the proportion of children ages 1-20 enrolled in Medicaid or CHIP for at least 90 continuous days who receive a preventive dental service by 10 percentage points between FFY 2011 and FFY 2015 - Increasing the proportion of children ages 6-9 enrolled in Medicaid or CHIP for at least 90 continuous days who receive a dental sealant on a permanent molar tooth by 10 percentage points

FLORIDA’S STATE ORAL HEALTH ACTION PLAN What’s included in the SOHAP? Describes and assesses the FL Medicaid dental delivery system Structure, current workforce participation, dental reimbursement rates, opportunities, and resources (which will improve dental service utilization and identify key barriers to preventive service utilization) Identifies key drivers of change and interventions needed to meet the CMS goals (using a driver diagram) FLORIDA’S STATE ORAL HEALTH ACTION PLAN How is the SOHAP going to help achieve these goals. By….

Sample Driver Diagram The interventions assist in achieving the secondary driver which drives the primary driver in achieving the ultimate goal, the AIM goal.

FLORIDA’S STATE ORAL HEALTH ACTION PLAN What’s included in the SOHAP? Describes and assesses FL’s Medicaid dental delivery system. Structure, current workforce participation, dental reimbursement rates, opportunities, and resources (which will improve dental service utilization and identify key barriers to preventive service utilization) Identifies key drivers of change and interventions needed to meet the CMS goals (using a driver diagram) Determines the resources needed to implement the interventions What barriers will we encounter? Potential solutions? What technical assistance will be needed from CMS to overcome these barriers? FLORIDA’S STATE ORAL HEALTH ACTION PLAN How is the SOHAP going to help achieve these goals. By…. Ultimately, a plan will be created to assess the success of each intervention and their drivers, including the data needed to do so. Examples of barriers: Limited number of providers in rural communities Administrative enrollment and managed care credentialing requirements Reimbursement Limited oral health literacy Examples of needed TA would be: Identify critical barriers to appropriate utilization or oral health care Identify proven and effective strategies/ best practices used by other Medicaid/CHIP programs for increasing participation rates with a focus on strategies that could be employed in a managed care delivery system. Identify strategies for increasing provider enrollment in meeting our goals, including financial and non-financial incentives. Aligning data collection methodologies from the managed care plans, health access settings, and other community patrners in order to produce more accurate federal reporting results.

Participants Florida Agency for Health Care Administration (Medicaid) Florida Dental Association Florida Dental Hygiene Association Florida Department of Health Florida Institute for Health Innovation Liberty Dental Plan Sunshine State Health Plan

Questions? Thank you for your time! Contact Information: Bob Reifinger Florida Agency for Health Care Administration Primary & Preventive Care Policy Robert.reifinger@ahca.myflorida.com