Maybe there’s a toothless pumpkin staring at me, but I started thinking about teeth, mouths, oral health, dentistry, and the strange landscape of American health policy. I don’t know about you, but my last mirror session confirmed that my teeth are in my mouth and inside my body. It has been.
There has been a fierce battle in the world of health policy over “mental health equality”. At its core, it is the idea that emotional well-being and physical well-being are related and should be treated holistically. (Health policy folks love the word across the board, so I started using it across the board.) So I slowly realized that it doesn’t make sense that oral health is disconnected from “wellness” and that dental care is not seen from a health care perspective.
A little digging reveals that the dental profession in the United States was initially supported by medical professionals, but in particular the American Dental Association achieved its political goals and, at its inauguration in 1965, was forced out of Medicare. A split occurred when it was left out. That explained the strange layout of the land, but what’s the right thing to do?
First, there is no doubt that there is a link between oral health and overall health. However, there are various dental hygiene procedures that are more or less related to overall health. Most of mine is vanity cleaning. Second, it’s easy to overstate how much better dental health care actually improves overall health.the real question is how Integrate oral health considerations into overall health benefits.
The private sector should have latitude in designing its plans to answer this question as it sees fit. For government programs such as Medicare, Medicaid, and the Affordable Care Act, simply adding unadjusted reimbursement dental benefits has no health impact, underfunding essential dental care, and generally can subsidize elective dental care that lacks the cost of dental care. progress. (Currently, children’s health insurance programs have limited dental benefits, just over half of Medicaid programs, and certain Medicare status.)
But wait. There is an existing system with the ability to provide dental benefits, consider oral interactions with other health, and distinguish between elective and mandatory oral health interventions: Medicare Advantage (MA). All seniors have access to MA plans that provide dental benefits (so it’s absolutely not true that Medicare doesn’t cover dental benefits).
MA provides an opportunity to develop real-world evidence of effective means for integrating oral health considerations into care plans. Another reason is to celebrate the fact that an increasing proportion of older adults (more than half in the near future) are choosing to enroll in MA.
Chart Review: Dental Coverage for Medicare Beneficiaries
Danielle Bartolotta, Health Policy Intern
Dental care is important for overall physical health, but a recent study found that baby boomers were the least likely age group to have dental insurance because many Medicare plans don’t offer it. It turns out that there is. The chart below shows the percentage of different dental plans among Medicare beneficiaries in 2012, 2016, and 2021, showing promising trends. The percentage of seniors without dental insurance has dropped from about 88% in 2012 to 47% in 2021. Medicare Advantage (MA) plans are responsible for the biggest increase in dental insurance. The percentage of beneficiaries of these plans has increased from 16% in 2016 to 26% in 2021. In addition, some beneficiaries have dental insurance by supplementing their Medicare plans with private insurance. The trend for older adults to supplement their Medicare coverage with private insurance or MA plans that include dental insurance creates an opportunity to integrate oral and physical health.
