11/11/2015

$750 million investment coming for Denti-Cal


California and the federal government have reached a significant agreement that will ensure an additional $750 million investment in California's Denti-Cal program over a five-year time frame. 

When California wants to make significant changes to its Medicaid program, one of the ways it goes about doing that is negotiating changes in the contract the state has with the federal Centers for Medicare and Medicaid Services (CMS). The negotiations between CMS and the state have been going on for the better part of the year, and CDA has been actively engaged — advocating for the state to focus some attention on the under-resourced Denti-Cal program. 

The majority of the funding dedicated through the waiver (a total of more than $6 billion) focuses on the medical portion of the state's Medicaid program, including investments in the state's public hospital system and a county-based pilot project to provide more integrated care for high-risk, vulnerable populations. The goal of the waiver is to reform the delivery system and develop outcome improvements with the long-term goal of reducing costs to the state and federal government.

While only high-level concepts of the "Dental Transformation" portion of the waiver have been agreed to at this point, there is a framework for the dental investments: incentives for early, preventive care; some form of implementation of Caries Management by Risk Assessment (CAMBRA); and a focus on continuity of care.  

CDA is advocating for the state to increase its support for early intervention and prevention services by implementing a version of the state of Washington's Access to Baby and Child Dentistry (ABCD) program, which provides greater reimbursement rates for prevention and basic care services for the 0- to 5-year-old population. CDA believes implementing this proven program would help the state improve access to much needed services, support dentists in their ability to participate in the program, and achieve the first goal of the wavier.  

CAMBRA is an evidenced-based approach to preventing or treating dental caries at the earliest stages, and conversations about how it might be implemented in a thoughtful, constructive way in the Denti-Cal program are already underway. 

Finally, regarding the focus on continuity of care, the state is still working on developing the concepts around this goal, and CDA will continue to work with them as it develops.    

The addition of $750 million over five years represents a tremendous investment in the Denti-Cal program, but a great amount of work and implementation planning is still required. The state has until Dec. 31 to develop these details and CDA will continue its advocacy.

For more information, contact CDA's Director of Public Policy Nicette Short at nicette.short@cda.org



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A new review of the state’s Denti-Cal program provides further evidence that current rates are insufficient and that there has been a significant decline in participating providers since 2008. Just released by the state Department of Health Care Services, the report shows that while there has been a nearly 40 percent increase in enrolled children and 77 percent increase in enrolled adults, there has been a double-digit decrease in providers in that same timeframe.

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