Last year about this time, we were reading about Covered California’s decision to require parents seeking pediatric dental coverage on the state’s new insurance exchange to buy separate stand-alone plans for their children.
Pediatric dental coverage was designated as one of 10 essential benefits under the Affordable Care Act (ACA). But most dental insurance is sold separately from other kinds of health insurance, and some people supported the idea of selling pediatric dental benefits separately on the state exchange. They contended that consumers who did not want or need pediatric dental benefits should not be required to buy them.
At the same time, Covered California’s plan to offer pediatric dental coverage through stand-alone plans came as a disappointment to oral health advocates. They argued that embedding dental benefits into the health care plans for sale on the state exchange would help expand children’s access to dental care and lower the costs of the benefits by distributing the burden of paying for them across a broader group of people.
After a hint from her own dentist, Sheila Hagar started looking into concerns about the rising numbers of Medicaid kids getting braces in Washington. Hagar, who is medical and social services reporter for the Union-Bulletin, in Walla Walla, sought sources and found statistics that made her jaw drop.
“We should be taking care of people who really have a need,” a frustrated Walla Walla orthodontist, Thomas Utt, D.D.S., told her. “While his office – Walla Walla Orthodontics – is authorized to treat Medicaid-eligible children with braces,” Hagar wrote, “Utt grits his teeth at what he sees as misuse of funds and a lack of clarity over just what ‘medically necessary’ means when it comes to correcting kids’ teeth.”
Here, Hagar tells us more about how she tackled the reporting that led to her July 5 package “State Foots Skyrocketing $27 Million Bill for Braces” and what she is learning about orthodontic benefits under Medicaid. She also shares some wisdom on what to do when no one is returning your calls on an uncomfortable subject. Read how she did her reporting.
Megan Sandel, M.D., M.P.H., an expert on the impact of housing on child health, says journalists would do well to broaden the conversation about health care to include questions about social support – especially support for safe, affordable and stable housing.
Sandel has contributed a tip sheet that includes key stories to pursue and critical insights on the housing-as-health-care trend.
Find out why housing has an enormous impact on educational attainment and economic stability, how unequal enforcement of health and safety codes creates disparities and what the three essential elements of healthy housing are. See the tip sheet now.
Have you visited a school-based dental sealant program in your state or community? There may be a good story there.
Can’t find one to visit? That may be another worthwhile story.
Dental sealants are thin, plastic coatings that are applied to children’s permanent back teeth to seal the narrow grooves on the chewing surfaces and keep out decay-causing bacteria and food particles. Studies show that the procedure can reduce the incidence of tooth decay by 60 percent.
But poor and high-risk kids who could benefit the most from sealants are not always receiving them.
This new tip sheet from Mary Otto, AHCJ’s oral health core topic leader, explains why not all children who should have sealants are getting them and how to check into it in your community. Read more …
Quite a few folks in Tennessee are upset right now with DentaQuest, the giant dental benefits company that took over the contract to provide oral health services to poor kids under the state’s Medicaid program earlier this year.
Two hundred black dentists are riled that they were cut from the provider network. The state dental association has withdrawn its support for DentaQuest’s contract. And some consumers (including a group home operator) are saying the company is making it harder for patients to get the care they need.
Meanwhile, company officials insist that no child with TennCare benefits has lost access to dental care under their watch. They defend their performance in Tennessee, saying that screenings have increased and that the state network of 864 providers – one for every 857 patients – exceeds nationally recommended standards.
What is going on? The Tennessean’s Tom Wilemon has been working to find out. His story last month offered a look at the situation.
In this Q&A, he gives an update and some additional insights into his reporting. He also shares some wisdom with others who might find themselves tackling a similar story.
The rumblings in Tennessee started earlier this year, after a new company took over the contract to provide dental services to the state’s children covered by Medicaid.
Now the state dental association, a number of black dentists, a youth-home operator and at least one angry grandmother are weighing in against the Boston-based dental benefits giant DentaQuest. They claim the company is making it harder for poor kids in the state to get dental care.
The Tennessean’s Tom Wilemon captured the mood in a June 6 story, “Complaints Mount about TennCare Dental Provider:” Continue reading
While beauticians and tattoo artists are regulated in the state of Oregon, midwife certification is voluntary and, even then, the hurdles for certification are rather minimal.
But with midwives largely operating outside of the established health care system, there was little more than anecdotal evidence about the safety of home births to go on. That changed last year.
Markian Hawryluk, a health reporter with The Bend (Ore.) Bulletin and an AHCJ Regional Health Journalism Fellow, describes how he took advantage of new data collected by the state of Oregon to shape an article that revealed high mortality rates for home births in his state.
“If home birth were a drug,” he wrote, “it would be taken off the market.”
Read more about how he reported the story and get links to resources he used.
State and federal policymakers should take steps to make dental benefits less costly and more widely available under the Affordable Care Act (ACA) according to a panel of experts convened by the nonprofit National Academy for State Health Policy.
While oral health advocates were heartened to see pediatric dental benefits included among the health reform law’s essential health benefits (EHB), the task of making them available on state marketplaces and getting consumers to buy them has proven to be complicated.
Dental benefits have traditionally been sold separately from other types of health insurance, and the “ACA and subsequent federal guidance treat pediatric dental benefits differently from the other EHB categories, creating unique challenges in implementing the vision of a guaranteed pediatric dental benefit,” concludes the experts’ report, released today. Continue reading
Photo: BlatantNews.com via Flickr
Recently, an editor sent me a study to cover on concussions in teenagers. At least, that’s what we thought the research was about, based on the title of its press release: “Teenagers who have had a concussion also have higher rates of suicide attempts.”
And I was excited to cover the study. Like gut bacteria and anything to do with chocolate or coffee or stem cells, concussion is a hot topic right now. That’s partly because brain scientists are just beginning to understand the lasting impacts of these sometimes subtle but probably cumulative injuries.
And they affect everybody from pro athletes to pee wee football players. So when parents and coaches see the word “concussion,” their thoughts rightfully turn to young athletes. About half of concussions in kids ages 8 to 19 are sports-related, according to a nationwide study of concussions published in 2010 in the journal Pediatrics.
The press release said the study found that kids who have had concussions were not only more likely to try to commit suicide, but to engage in other sorts of high-risk behaviors like taking drugs, stealing cars, setting fires and bullying.
The message here is that a kid who gets hit in the head too many times – presumably playing sports – might turn to drug abuse, self-injury and other sorts of criminal behaviors. And that’s the way it was covered in the press. Continue reading
Image by Victor Bonomi via flickr.
We know that about 45 percent of American kids are growing up in families that are poor or near poor, and that this degree of social inequality helps explain why the health status of Americans is failing to keep up with progress in other wealthy nations.
But how to make things better is not so clear, I insisted in a recent post. I may have spoken too soon. There is now solid evidence from a long-running study in North Carolina that early childhood programs can produce health benefits that persist into adulthood. Continue reading