Impact Report 2022

In 2021, as HDA evaluated past efforts and developed a new three-year strategic plan, it identified a lack of relevant data to develop policies supporting the oral health of the Hispanic community. According to the 2020 census, for example, Hispanics represent approximately 18.5% of the total population, but only about 6% of dental health care providers are Hispanic — a number HDA is trying to help grow.

Connecting with CareQuest Institute, a longtime partner, a previous grantor, and a leader in oral health analytics and data insights, was the next logical step.

“Having respectable data that can be used to convince people,” Mutis says. “I think CareQuest Institute is the leader when it comes to that.”

The project is an important one in CareQuest Institute’s portfolio of work, which yielded more than 110 publications on topics ranging from alternative payment models to teledentistry in 2022. The industry-leading data contain anonymized oral health information about 33.5 million individuals in the US, largely focusing on underserved populations that lack benefits and access.

Access is one thing Mercedes Mota-Martinez, DDS, president of HDA, points to as a key barrier to adequate care for the Hispanic population.

“We do rich campaigns around health literacy,” she says, “but once people come home, and decide they need to go see the dentist, they have to have access to a dental plan, or financial resources to pay for care.”

Data can be one way to open the door to that access.

“We see the data and information we’re sharing to be a significant contribution because it’s going to eventually affect the monies that are spent in the US around health care,” says Mutis. “And it will strengthen that message that good oral health leads to better overall health.”

“MORE Care was amazing,” Boughton says.

Program teams work to assist medical practices in developing the skills and adopting the processes necessary to integrate oral health services into their existing workflows. Collaboration and learning alongside other organizations are critical to success of the program.

“Sometimes bringing on another project can feel so overwhelming,” Boughton says. “But being able to talk with other professionals who had implemented oral health into their practices was so helpful. In the trainings, you could bounce ideas off each other and ask questions. We could help, encourage, and empower each other.”

The same collaboration happens in the Community Oral Health Transformation (COrHT) Initiative, a framework for safety net dental clinics to implement medical-dental integration and value-based care. Raydiance Swanston, a health program manager at Mecklenburg County Pediatric Clinic, values those interactions as part of ongoing work with CareQuest Institute in North Carolina.

“We’re trying to make a difference for people who need a voice, to service every person in this community and be an oral health champion,” she says.

Both COrHT and MORE Care focus on enabling community oral health solutions that support accessible, integrated care for the whole patient.

“It is very important that we remove systemic barriers to good oral health,” Swanston says, “and accelerate the implementation of policies that reduce oral health disparities in our community.”

“We’re lucky to have CareQuest Institute helping and investing money in this,” Davis says.

Every year, CareQuest Institute invests strategically to strengthen communities and improve our oral and overall health systems. In 2022, the organization invested $14 million to 86 grantee organizations, 33% of which are BIPOC-led organizations.

NPAIHB is an ideal grantee. Growing and improving the program mean more people in more communities will have more opportunities for jobs within their communities and greater access to quality dental care — care from people they know and trust. In 2022, Davis hired Pam Ready, a dental hygienist, professor, dental hygiene educator, and a member of the Puyallup Tribe of Indians. Ready serves as the dental health aide education manager for the team.

TCHPP’s work has become so popular that it is creating a capacity problem. More high schools in Washington and Oregon are interested in offering courses about dental careers and in providing the dental health aide core curriculum, so Davis plans to increase both the quality and capacity of TCHPP.

“Without the grant from CareQuest Institute, I wouldn’t have been able to hire Pam and Kari [Kuntzelman, a dental health aide therapist and a member of the Chickasaw Nation] . . . and they are both amazing,” Davis says.

That experience leads to much better care for patients.

“When dental health aides and dental therapists are also community members, the kids know them and the adults trust them, because it’s a familiar face,” Davis says. “People have a positive experience with their dental care and want to go back.”

Now, 15 years after MDAC and the advocate community began its work, on May 12, 2022, Maryland Governor Larry Hogan signed SB150/HB 6 into law, which creates a Medicaid dental benefit for all adults. Starting on January 1, 2023, 800,000 Maryland Medicaid adult beneficiaries will gain access to comprehensive dental coverage, including diagnostic, preventive, periodontal, and restorative services. There is no cap or annual maximum applied to coverage, which will allow all individual patient needs to be met in a timely manner.

Backley and Robyn Elliott, MDAC’s policy and governmental affairs consultant, fondly recall the day they were waiting for the final vote on the bill.

“We ended up getting everything we needed in the bill, which was, and is to this day, amazing,” says Elliott. “Then, it was one of the best phone calls I’ve ever made in my life to Mary, who was the first person I called to tell the news.”

To help build the case, MDAC partnered with — and received a grant from — CareQuest Institute on a study related to how much Maryland’s state Medicaid program was paying for emergency room visits for non-traumatic dental conditions. The study revealed that the state was spending $10 million per year for these visits, which are costly, ineffective, and largely avoidable with accessible preventive dental care.

“I get a lot of calls to our office from people who are desperate and asking where they can get dental care,” says Backley. “Now when I get those calls, I can tell people that they will have dental coverage under the new law, starting January 2023.”

Now, MDAC will shift its focus to implementation, working with partners and stakeholders on a significant education and outreach campaign to help people enroll in coverage.