Impact of AllCare Healths First Tooth Training Laura McKeane, - PowerPoint PPT Presentation

Impact of AllCare Health’s First Tooth Training Laura McKeane, AllCare Health Sarah Bartelmann, CORE 1

Background 2

Dental caries (tooth decay) are the most common chronic disease in children ages 6+ 49% of children ages 6-9 in Oregon had a cavity in 2017 19% of children ages 6-9 in Oregon had untreated decay 2017 69% of Oregon 8 th graders and 75% of 11 th graders have had 1+ cavities, 2015 Preliminary data from 2017 Oregon Smile Survey; other data from Oregon Oral Health Surveillance System (2012-2016) 3

Only half of Oregon children and adolescents (ages 0-18) on Medicaid received preventive dental services in 2016 Oregon 50.1% AllCare Health 44.1% Data from Oral Health in Oregon’s CCOs report (2017) 4

82% of parents of AllCare Health enrolled children said their children had a regular dentist PacificSource Gorge 86.7% Cascade Health Alliance 86.6% Jackson Care Connect 85.7% Yamhill Community Care 85.7% Eastern Oregon 84.4% Advanced Health 83.1% AllCare Health 82.2% PacificSource Central 81.6% Willamette Valley Community Health 81.4% Umpqua Health Alliance 81.2% InterCommunity Health Network 79.6% Health Share of Oregon 79.3% PrimaryHealth 78.9% Columbia Pacific 76.9% Trillium 71.5% Data from CAHPS: Access to Dental Care - Children measure, 2018 CCO Metrics Performance Report 5

Intervention 6

AllCare Health prioritized oral health Allowed reimbursement for oral health assessments up to age 19 Launched Dental Alternate Payment Model (APM) in July 2015 Offered First Tooth training for providers 7

First Tooth The goal of the First Tooth program is to reduce childhood caries by training Training Includes providers to implement preventive oral • In-office training (1.5 – 2 hours) health services for children • Training for all providers / staff • Instruction on fluoride varnish application • Culturally appropriate materials First Tooth was launched by the Oregon • Guidelines to refer children to dental homes Oral Health Program and the Oregon • Continued support for implementation Oral Health Coalition in 2009 8

AllCare Health invested in First Tooth training Providers receiving First Tooth training across Coos, Curry, Douglas, Jackson, and Josephine counties 47 56 185 70 72 2011 2012 2013 2014 2015 2016 2017 9

To learn more about First Tooth training Visit www.orohc.org/first-tooth/ Or contact: Laura McKeane Laura.McKeane@allcarehealth.com Alexa Jett jetta@careoregon.org 10

Evaluation 11

How did AllCare Health’s efforts to spread the First Tooth program impact the use of oral health and dental services in children and adolescents 12

Evaluation Design We included: Then we sorted into groups: AllCare Health members ages 0-19 Cases : Children with at least one visit with a medical provider who • Who were enrolled for 6 months had previously attended a First • Who had at least one primary care Tooth training and was billing visit between 2014-2016 • Who did not receive care at FQHC Controls: Children who did not visit a medical provider who had been =35% of AllCare Health’s population trained and was billing 13

The percent of younger children receiving oral health assessments increased in 2015 6% 6% Children ages 0-6 1% Children ages 7-19 0% 0% 2014 2015 2016 14

Younger children (ages 0-6) who saw a medical provider who had received First Tooth training were more likely to receive fluoride varnishes 55% Children who saw a trained provider 47% 35% 32% 30% Children who saw other providers 27% 2014 2015 2016 15

Older children (ages 7-19) who saw a medical provider who had received First Tooth training were more likely to receive any dental service 62% Children who saw a trained provider 63% 55% 57% Children who saw other providers 55% 47% 2014 2015 2016 16

Conclusions AllCare Health members who saw First Tooth trained providers were … more likely to receive oral health assessments (younger children) … more likely to receive fluoride varnish (younger children) … more likely to receive any dental service (older children) Use of dental services are increasing in general, which may be affected by … CCO incentive metrics … AllCare Health’s dental Alternative Payment Model 17

Next Steps 18

Expanded Evaluation Include … Medical providers who were trained in 2017 and 2018 … Dental utilization through 2018 Explore … Multiple visits with a First Tooth trained provider … Siblings of children who had a visit with a trained provider Results expected December 2019 19

Program and Policy in Partnership with OrOHC Update First Tooth curriculum to meet new metrics for CCOs and DCOs Update and disseminate curricula for Oral Health for Chronic Disease and Maternity Teeth for Two Expand access to First Tooth for primary care providers and allied dental practitioners across Oregon Launch a data portal to track First Tooth certification that will be integrated with First Tooth online training 20

Laura McKeane Laura.McKeane@allcarehealth.com Contact Us Sarah Bartelmann Sarah.Bartelmann@providence.org 21