July 2017

July 11, 2017

HPC Chart: Oral Health ED Visits

We smiled brightly during the Health Policy Commission’s (HPC) July 5 meeting because the agency highlighted one of our top priorities, the lack of access to oral health care. In their first DataPoint analysis, HPC found 11.5% reduction in oral health-related hospital Emergency Department (ED) visits from 2013 – 2015.

But despite this overall reduction in costly and preventable care, there was a substantial increase in oral health ED visits for elementary school aged children and adults age 55 to 84. Moreover, and perhaps most concerning, is that low-income populations accounted for a disproportionate rate of oral health ED visits.

It is unclear whether the overall decrease in ED utilization is attributable to certain demographics receiving better quality preventive care or increased access to dental services. What is clear, however, is that glaring inequities exist in dental care access, causing low-income populations to over-utilize hospital EDs.

This costly outcome occurs because we neither equip EDs to treat dental conditions nor train emergency room physicians to resolve these issues. And even if EDs could provide proper dental care, these visits are preventable and burdensome on hospitals.

Ultimately, this data suggests that that access to dental care remains elusive in Massachusetts even though coverage may in fact be increasing.

This is why we agree with Governor Baker, Secretary Sudders, and the Executive Director of the HPC, David Seltz, in their support of legislation to authorize dental therapists. This common sense policy would expand quality and access to preventive oral health care to vulnerable populations.

Dental therapists, who would reach out to patients, providing care in places like schools or nursing homes, can greatly reduce oral health-related ED utilization. After all, the patients most likely to utilize ED for dental care – children and seniors – are society’s least mobile. Dental therapists meet their needs by going to them  where they are and providing the care they need at a lower cost.

Dental therapists offer low-cost interventions that can prevent more costly illnesses. They would be reimbursed by MassHealth, expanding access to people who have some coverage, but are still unable to receive appropriate oral health care.

Legislation is pending that would allow dental therapists to practice in Massachusetts. Hearings should occur this fall. This is a key HCFA priority for this fall, and we urge you to join our campaign.

                                                                                                                                                                           - Ben Agatston

July 6, 2017

The Prevention and Public Health Fund was established in 2010 as part of the Affordable Care Act. As the nation’s first mandatory fund dedicated to improving public health, this fund has played a major role in funding prevention programs throughout the country. The current proposed legislation to repeal the Affordable Care Act would eliminate this fund.

This fund provided $17 million to Massachusetts during fiscal year 2016. The programs that benefited include programs dedicated to combating racial and ethnic health disparities, providing immunizations for children, and increasing prevention and control for heart disease, strokes, and diabetes. A new study reports that If the fund is repealed, Massachusetts will lose over $88 million over the next five years.

Preventable diseases are a major health care issue. These diseases cause an estimated 70% of all deaths, and are the main cause for around 75% of health care spending. Yet only about 3 percent of health care spending goes towards preventing these same diseases.

For Massachusetts, repealing this fund along with the ACA would mean cuts in valuable programs such as

  • vaccines for children ($3.6 million);
  • diabetes and heart disease prevention programs ($5 million);
  • lead poisoning prevention and tobacco cessation ($780,000).

The funds also supports $2.3 million to combat racial and ethnic health disparities.

Prevention programs are an important and under-utilized method for addressing these diseases. Supporting prevention programs is a fiscally responsible strategy - it's cheaper to prevent illness now than treat them later. Prevention programs help improve quality of life and reduce death rates by helping individuals combat preventable diseases.

Yet another reason to oppose the plans to "repeal and replace" the Affordable Care Act.

                                                                                                                                                           - Sean Connally