Publications

The North Carolina Oral Health Action Plan for Children Enrolled in Medicaid and NC Health Choice (2013)

Abstract

In the fall of 2012, the Centers for Medicare and Medicaid Services (CMS) launched an oral health initiative aimed at increasing the percentage of children enrolled in Medicaid or Child Health Insurance Programs (CHIP) who receive preventive dental services and dental sealants. CMS oversees Medicaid and CHIP in all states. CMS launched this oral health initiative in response to low utilization rates for preventive dental services across the country. In North Carolina, children with family incomes below 200% of the federal poverty level qualify for health care coverage, including dental services, through Medicaid or NC Health Choice, North Carolina’s State Child Health Insurance Program.4-6 The North Carolina Institute of Medicine Task Force on Children’s Preventive Oral Health Services was convened to help the Division of Medical Assistance (DMA) develop a dental action plan to improve access to preventive oral health services for children enrolled in Medicaid and NC Health Choice, as required by CMS. The Task Force is a collaboration between DMA, the Blue Cross and Blue Shield of North Carolina Foundation (BCBSNCF), the Oral Health Section within the North Carolina Division of Public Health, and the Office of Rural Health and Community Care. This report summarizes the findings of the Task Force and their recommendations to increase utilization of oral health services by children enrolled in Medicaid and NC Health Choice.

Full Description

Tooth decay is the most common chronic disease among children ages 5 to 19, affecting approximately 1 in 5 children. In North Carolina, 14 percent of children in kindergarten (ages 5-6) have untreated dental decay in at least one primary tooth. A number of factors put some children at greater risk of developing dental cavities, particularly low socioeconomic status and minority race/ethnicity. With proper dental care and dietary choices, dental cavities and decay could almost be eliminated among children. While North Carolina has made tremendous improvements in dental service utilization by children enrolled in Medicaid and NC Health Choice over the past decade, there is still room for improvement. Only 45 percent of children enrolled in Medicaid and 49 percent of the children enrolled in NC Health Choice received at least one preventive service from a dentist in 2012.

In response to low utilization rates nationally, the Centers for Medicare and Medicaid Services asked all states to develop plans to improve utilization of preventive dental services. The North Carolina Institute of Medicine Task Force on Children’s Preventive Oral Health Services, in partnership with the North Carolina Division of Medical Assistance and others, studied the issue of how to increase utilization of preventive dental services by children enrolled in Medicaid and NC Health Choice and developed a series of policy recommendations. The North Carolina Oral Health Action Plan for Children Enrolled in Medicaid and NC Health Choice includes a wide variety of recommendations that could be pursued and promoted by both public and private stakeholders. The report includes a multifaceted approach that, if implemented, will significantly improve access and utilization of preventive oral health services by children enrolled in Medicaid and NC Health Choice, thus helping the state meet the goals set forth by the Centers for Medicaid and Medicare Services. In turn, this will help promote the health and well-being of some of our most vulnerable children.