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In on the exchange
The Medicaid expansion falls second on the NADP priority list, and Ireland said the final push the association is making is for a dental component to be included in any national health care exchange program that might be created. The exchange would be a system to allow small businesses and individuals to buy into larger commercial health care plans.

If an exchange is created, Ireland thinks dental care should be a service it offers. However, she does not want to see dental care lumped in to overall plans because with its focus on covering preventive services, reliance on individual providers rather than hospital-based networks and fewer issues of coverage portability between providers and insurance plans, the dental system is different than the medical system.

Ideally NADP would like to see a plan the preserves the employer provided, untaxed dental insurance system currently in place with expansions of access for individuals through the exchange and a more robust Medicaid program to fund coverage for low income segments of the population. A key to these efforts will be to make sure the language of the reform legislation specifically defines dental coverage out of changes that would harm the existing system, Ireland said.

“If what we’ve proposed happens, then everyone would have access with the federal government funding only those that are most needy,” she added.

IT compatibility
Properly defining dental issues in the legislation is a key component to making sure dental’s needs are met if a federal system of electronic health records are adopted. The federal government is pushing for expansion of electronic records as a way to reduce costs and improve care quality.

However, with the dental and medical systems using different coding systems, Prentice said any requirements for national standards on electronic records must take the current structure of dental records into account. That way the existing dental electronic patient record systems can be rolled into the overall electronic health records for patients.

“You don’t want dentists to have the beta-max of health IT and then in a couple of years have to retrofit everything,” he said. “You want to make sure that if and when something is mandated it’s done correctly and makes sense.”

For now both ADA and NADP plan to keep close watch on the development of the plans in Congress so they can speak up when the issues they’ve targeted come up for discussion. Both Prentice and Ireland said they’re aware dental issues are often viewed as a sidetrack when they’re considered at all in the national debate. Still, that doesn’t mean changes to the system wont impact the dental industry, so they plan to work at ensuring any impact is positive for dental providers and the nation’s oral health.

“Until they were completed with a structure for the medical side of things, they haven’t really wanted to talk about oral health,” Ireland said. “That doesn’t mean that dental and oral health is not going to end up in health care reform.”

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