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Impact of AllCare Health’s First Tooth Training
Laura McKeane, AllCare Health Sarah Bartelmann, CORE
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Background
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Impact of AllCare Healths First Tooth Training Laura McKeane, - - PowerPoint PPT Presentation
Impact of AllCare Healths First Tooth Training Laura McKeane, - - PowerPoint PPT Presentation
Impact of AllCare Healths 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
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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 8th graders and 75% of 11th graders have had 1+ cavities, 2015
Preliminary data from 2017 Oregon Smile Survey; other data from Oregon Oral Health Surveillance System (2012-2016) 3
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Only half of Oregon children and adolescents (ages 0-18) on Medicaid received preventive dental services in 2016
Data from Oral Health in Oregon’s CCOs report (2017)
44.1% 50.1% AllCare Health Oregon
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82% of parents of AllCare Health enrolled children said their children had a regular dentist
Data from CAHPS: Access to Dental Care - Children measure, 2018 CCO Metrics Performance Report
71.5% 76.9% 78.9% 79.3% 79.6% 81.2% 81.4% 81.6% 82.2% 83.1% 84.4% 85.7% 85.7% 86.6% 86.7% Trillium Columbia Pacific PrimaryHealth Health Share of Oregon InterCommunity Health Network Umpqua Health Alliance Willamette Valley Community Health PacificSource Central AllCare Health Advanced Health Eastern Oregon Yamhill Community Care Jackson Care Connect Cascade Health Alliance PacificSource Gorge
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Intervention
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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
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First Tooth
The goal of the First Tooth program is to reduce childhood caries by training providers to implement preventive oral health services for children First Tooth was launched by the Oregon Oral Health Program and the Oregon Oral Health Coalition in 2009
Training Includes
- In-office training (1.5 – 2 hours)
- Training for all providers / staff
- Instruction on fluoride varnish application
- Culturally appropriate materials
- Guidelines to refer children to dental homes
- Continued support for implementation
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AllCare Health invested in First Tooth training
9 47 56 185 70 72 2011 2012 2013 2014 2015 2016 2017
Providers receiving First Tooth training across Coos, Curry, Douglas, Jackson, and Josephine counties
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To learn more about First Tooth training
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Visit www.orohc.org/first-tooth/ Or contact: Laura McKeane Laura.McKeane@allcarehealth.com Alexa Jett jetta@careoregon.org
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Evaluation
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How did AllCare Health’s efforts to spread the First Tooth program impact the use
- f oral health and dental
services in children and adolescents
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Evaluation Design
We included:
AllCare Health members ages 0-19
- Who were enrolled for 6 months
- Who had at least one primary care
visit between 2014-2016
- Who did not receive care at FQHC
=35% of AllCare Health’s population
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Then we sorted into groups:
Cases: Children with at least one visit with a medical provider who had previously attended a First Tooth training and was billing Controls: Children who did not visit a medical provider who had been trained and was billing
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The percent of younger children receiving oral health assessments increased in 2015
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0% 6% 6% 0% 1% 2014 2015 2016
Children ages 7-19 Children ages 0-6
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Younger children (ages 0-6) who saw a medical provider who had received First Tooth training were more likely to receive fluoride varnishes
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35% 47% 55% 27% 30% 32% 2014 2015 2016
Children who saw a trained provider Children who saw other providers
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Older children (ages 7-19) who saw a medical provider who had received First Tooth training were more likely to receive any dental service
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55% 62% 63% 47% 55% 57% 2014 2015 2016
Children who saw a trained provider Children who saw other providers
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Conclusions
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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
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Next Steps
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Expanded Evaluation
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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
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Program and Policy in Partnership with OrOHC
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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
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Contact Us
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Laura McKeane Laura.McKeane@allcarehealth.com Sarah Bartelmann Sarah.Bartelmann@providence.org