Dental home pilot projects could offer alternatives for public health program enrollees

Minnesota has struggled to ensure dental care access for people on its public health programs for a long time.

“The share of kids getting dental care on Medical Assistance (is) less than 40%,” said Rep. Liz Reyer (DFL-Eagan). “This is a core health and equity problem that we are obligated to address for both practical and moral reasons.”

She sponsors HF1918, which would require the Department of Human Services to establish an advisory committee to lay the groundwork for a dental home pilot project – which could provide a more effective alternative to the state’s Critical Access Dental Payment Program.

The House Health Finance and Policy Committee laid the bill over Tuesday for possible inclusion in an omnibus bill. There is no Senate companion.

“Dental homes” are not necessarily brick-and-mortar buildings, but an approach toward dentistry that allows for multiple points of entry, emphasizes accessibility, and could provide incentives for the provision of high-quality, continuous, patient-centered care, said Dr. Sheila Riggs, who chairs the Department of Primary Dental Care at the University of Minnesota School of Dentistry.

Comprehensive, patient-centered services could be provided in community settings like schools, shelters, and congregate living facilities, Reyer said.

The pilot project would be designed to evaluate approaches that:

• establish simpler and more flexible enrollment options for providers serving Medical Assistance and MinnesotaCare enrollees;
• establish value-based incentives to increase provider participation, reduce disparities, and improve quality of care;
• improve transparency and accountability; and
• coordinate care.

It would not be modeled off of any specific programs in other states, but would draw from available evidence and data while addressing Minnesota-specific struggles and leveraging Minnesota-specific advantages – like existing workforce innovations and promising initiatives that are already underway, but need testing and evaluation, Riggs said.

The 15-member advisory committee responsible for developing the pilot project would include representatives from the Department of Health, Minnesota Dental Association, Minnesota Dental Homes Collaborative, dental school programs, dental providers serving Medical Assistance and MinnesotaCare enrollees, and public members representing the people served.

The Department of Human Services would provide staff and other administrative support.

Recommendations would be due to the Legislature by Dec. 15, 2021.