Dental therapists have the potential to expand access to oral health care, though opponents (such as the American Dental Association) argue that only dentists should perform surgical procedures such as restorations and extractions.
The rules around what dental therapists can do depend on the state. Minnesota authorized the licensing of dental therapists in 2009. But dental health aide therapists started providing care in Alaskan villages in 2005. Working under the general supervision of dentists, DHATS provide access to care to more than 40,000 Alaska Natives, many of them living in remote and isolated areas.
We’ve updated the oral health core topic area with more information about dental therapists.
There are new entries in the glossary, key concepts section and some data that looks at New Zealand’s use of dental therapists, where they’ve been practicing since 1921, and explores use of the model in the United States.
It’s worth seeing what the rules are in your state and whether there is a movement to allow dental therapists to provide more care. Check and see if there are “Dental Health Professional Shortage Areas” near you and talk to health professionals about whether dental therapists might improve access to care.
Image by Images_of_Money via flickr.
The greatest public health problem is not heart disease. It’s not cancer. And it’s not mental health.
It’s inequality. That’s according to a Canadian health policy analyst quoted by André Picard in a notable series in the Toronto-based newspaper The Globe and Mail.
The Globe‘s Wealth Paradox series, published over two weeks in November, explores how Canada’s increasing wealth gap is reshaping society and putting future generations at a disadvantage. The Globe being a business newspaper, the series makes a business case for taking the threat seriously. It’s full of story ideas that can be transposed onto U.S. turf.
Picard’s piece, Wealth begets health: Why universal medical care only goes so far, dug into the heavy health impact of income inequality despite Canada’s longstanding provision of medical care to all: Continue reading
What’s really happening with aging policy in Washington? At last week’s annual Gerontological Society of America Conference in New Orleans, a standing-room-only audience was privy to updates from key Congressional committee staffers.
Erika Salway, policy adviser for the Senate Health, Education, Labor and Pensions Subcommittee on Primary Health and Aging, discussed the committee’s work on issues affecting older adults, including federally qualified health centers, primary care, oral health, mental health and the Older Americans Act. Funding for the OAA is $1.8 billion, which may sound high, but she reminded the audience that its programs serve 10 million seniors every year and funding constitutes less than .06 percent of the federal budget. The OAA funds essential services such as Meals on Wheels, job training, caregiver support, transportation and elder abuse services. It expired in 2011 but continues to receive federal funds under the old legislative formula. Continue reading
Late Wednesday, the Centers for Medicare and Medicaid Services released its final hospital outpatient and ambulatory surgical center payment schedule for the 2014 fiscal year. A revised payment approach is designed to help hospitals and ambulatory surgical centers (ASCs) lower costs and strengthen Medicare’s long-term stability. One single code describing all outpatient clinic visits will replace the current five levels. CMS said this will encourage more efficient delivery of outpatient facility services by packaging the payment for multiple supporting items and services into a single payment for a primary service similar to the way Medicare pays for hospital inpatient care.
According to a story in Modern Healthcare, the move was triggered, in part, because too many hospitals practice upcoding – illegally picking billing codes that reimburse at higher rates than actual services provided. In a statement, Rick Pollack, executive vice president of the American Hospital Association said they are “extremely disappointed” with the new rule, which may hurt hospitals’ ability to provide outpatient care. The organization contends that CMS did not use accurate data when forecasting future reimbursements. “CMS has put hospitals in the difficult position of having only 35 days to implement significant changes in Medicare’s policies, procedures and payment formulas,” Pollack said. Continue reading
Here’s another HealthCare.gov problem – and a workaround – that haven’t gotten much attention.
People can apply for Medicaid (traditional or expanded) via the federal HealthCare.gov website. But the applications still have to get transferred to the states which have to process them to finalize enrollment in the actual state program. And it’s supposed to be done by Jan. 1.
Guess what? That was a problem. With all the website woes, the feds weren’t able to process that information and had pushed back deadlines. Then, quietly, on the Friday of Thanksgiving weekend, CMS offered a transitional “administrative” fix through this federal policy guidance.
The states are allowed to use the minimal information on the so-called “flat files” to finalize the Medicaid status. The flat files had been pretty bare bones but CMS says expanded files will “include data elements such as: date of birth, Social Security number, eligibility category used for assessment or determination, and verification inconsistencies. The file will identify individuals who have been assessed or determined eligible for Medicaid and CHIP on the basis of modified adjusted gross income (MAGI).”
It would be good to check in with your state’s Medicaid director. Is this enough? Too little, too late? Will people be correctly enrolled in Medicaid by Jan. 1 – or will some be left uncovered, even if they did their part of the application process correctly?
Here’s a list of state Medicaid directors from the National Association of Medicaid Directors.
Humans have searched for a “fountain of youth” since before the time of Ponce de León. Now scientists may be on track to find a so-called “longevity gene.” SIRT3, part of a class of proteins known as sirtuins, help stem cells cope with stress. A study in mice by researchers at the University of California, Berkeley, points to potential for their findings to someday help scientists find targeted treatments for aging-related degenerative diseases. Researchers were able to turn back the molecular clock of older mice when their blood was infused with the proteins – triggering stem cell’s rejuvenating potential similar to that found in younger mice.
Get more resources to understand more about the “longevity gene” and how genetics affects healthy aging with these links in AHCJ’s Aging core topic area.
One of the most important skills required of reporters who cover medical research is the ability to find and discuss the limits of the studies we cover.
To that end, a trio of professors at Cambridge University recently published a helpful comment in the journal Nature: “Twenty Tips for Interpreting Scientific Claims.” (If you don’t subscribe, you can read the full article for free here.)
Some of my favorites (in no particular order):
- Study relevance limits generalizations – a great reminder that the conditions of any study will limit how its findings can be applied in the real world.
- Bias is rife – We talk about several types of bias in the topic section, like reporting bias and healthy user effect. The article reminds us that even the color of a tablet can shade how study participants feel. Continue reading
The Association of Health Care Journalists has awarded five journalists AHCJ Reporting Fellowships on Health Care Performance. The program, in its fourth year, is meant to help journalists understand and report on the performance of local health care markets and the U.S. health system as a whole.
The fellowship program, supported by The Commonwealth Fund, is intended to give experienced print, broadcast and online reporters an opportunity to concentrate on the performance of health care systems – or significant parts of those systems – locally, regionally or nationally. The fellows are able to examine policies, practices and outcomes, as well as the roles of various stakeholders.
Read about the fellows and the projects they will be working on.
Here are two issues to watch in the coming year: How many employers will drop health insurance coverage in the next five years and how much will employers’ health benefit costs rise in 2014?
These issues jumped out from the results of the annual survey by benefits consultant Mercer. Within five years, 31 percent of small employers believe they will drop health insurance coverage, the survey showed. Mercer defines small employers as having 10 to 499 workers. The 31 percent level is up from the 22 percent of responding small employers who said last year they planned to drop health insurance coverage and up from the 19 percent who said they would drop health benefits in 2011, Mercer said.
Beth Umland, Mercer’s director of research for health and benefits, offered more detail. “While 31 percent of employers with 10 to 499 employees say it’s likely they will terminate, when we look at just those companies with 50 to 499 employees, that number falls to 21 percent,” she said. “The smaller the employer, the more likely they are to say they will drop. Continue reading
Photo: Carla K. Johnson
Dan Lustig, C. Scott Litch and Dr. John Rutkausas (left to right) spoke on a panel in Chicago about the Affordable Care Act.
Plenty of good story ideas await journalists willing to explore the nooks and crannies of the nation’s health care law. The Chicago chapter of AHCJ delved into some of these story ideas at a recent meeting titled “Fresh Stories Ahead for the Affordable Care Act.”
For instance, dental coverage for children is an essential health benefit under the law. Consumers in Illinois are able to buy pediatric dental coverage as a stand-alone plan, bundled with a medical plan or “embedded” into a medical plan. Panelist Dr. John R. Rutkausas, chief executive officer of the Chicago-based American Academy of Pediatric Dentistry, predicts consumers will be disappointed if they buy an embedded plan with a high deductible. It may be a rude surprise to learn they may have to pay all their children’s dental care out of pocket because they haven’t yet met their deductible. Continue reading