Doral Presentation: DAC Meeting November 21, 2008 (PPT)


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Doral Presentation: DAC Meeting November 21, 2008 (PPT)

  1. 1. DENTAL ADVISORY COMMITTEE November 21, 2008 Richmond, Virginia
  2. 2. <ul><li>The number of children ages 0-20 who received dental services increased from 219,968 in FY 2007 to 240,973 in FY 2008. </li></ul><ul><ul><li>38% of children in this age group utilized dental services (compared to 35% SFY2007 and 24% when the program started. </li></ul></ul><ul><li>The number of children ages 3-20 who received dental services increased from 211,445 in FY 2007 to 230,250 in FY 2008. </li></ul><ul><ul><li>46% of children in this age group utilized dental services (compared to 43% in SFY 2007 and 29% when the program started. </li></ul></ul><ul><li>The cumulative increase in utilization represent an approximate 74% increase for ages 0-20 and 70% increase for ages 3-20 since the start of the SFC program on 7/1/05. </li></ul>Increases in Medicaid/FAMIS Dental Utilization
  3. 3. HEDIS <ul><li>For the SFC program, the percentage of members 2–21 years of age who had at least one dental visit during calendar year 2007 was 53.84 %. </li></ul><ul><ul><li>The SFC HEDIS score is higher than the average for this region, the South Atlantic Region, 43.87%. </li></ul></ul><ul><ul><li>The SFC HEDIS score is also higher than the National Average of 43.55%. </li></ul></ul><ul><ul><li>The SFC HEDIS score falls between the 75 th and 90 th percentiles. </li></ul></ul>
  4. 4. Adult Dental Utilization <ul><li>Adult dental utilization has steadily increased since the inception of Smiles For Children . </li></ul><ul><ul><li>This represents a 200% increase from SFY 2006 to SFY 2008. </li></ul></ul><ul><li>Between July 1, 2005 – October 31, 2008, 606 providers submitted claims for services rendered to adults. </li></ul>$2,971,733.00 44,138 6,960 SFY 2008 $1,453,696.00 21,275 3,850 SFY 2007 $657,849.00 10,724 2,323 SFY 2006 DOLLARS$ CLAIM VOLUME NUMBER OF ADULTS YEAR
  5. 5. Member Outreach <ul><li>Postcard Reminder Activity </li></ul><ul><ul><li>Postcard reminder notices mailed to enrollees residing in Richmond, Fairfax, Roanoke and Virginia Beach that have no record of receiving dental service 7/1/06-6/30/07. </li></ul></ul><ul><ul><li>Additional outreach made to a segment of the members receiving a post-card reminder. These members received an outbound call following up on the post-card mailing. </li></ul></ul><ul><ul><li>A comparison of the response rate for members receiving only a post-card vs. members receiving a post-card and outbound call is currently underway to determine the effectiveness of each outreach methodology. </li></ul></ul><ul><li>Newly Developed Oral Health Literature </li></ul><ul><ul><li>Oral health education literature is being expanded to include the following topics: </li></ul></ul><ul><ul><ul><li>Member-focused Periodicity Schedule </li></ul></ul></ul><ul><ul><ul><li>Broken Appointments and Importance of Treatment Compliance </li></ul></ul></ul><ul><ul><ul><li>Find a Provider </li></ul></ul></ul>
  6. 6. Increase in Provider Network <ul><li>The number of providers enrolled in the dental program continues to increase: </li></ul><ul><ul><li>As of October 31, 2008, there has been an 83% increase in the number of providers since July 1, 2005. </li></ul></ul>
  7. 7. Network Recruitment <ul><li>Targeted cities/counties for recruitment identified based on data from Request A Dentist reports and utilization reports. </li></ul><ul><li>Planned Actions : </li></ul><ul><ul><li>Recruitment packets mailed to licensed Dentists. </li></ul></ul><ul><ul><li>Follow-up phone calls to assess interest and availability to participate in the SFC program. </li></ul></ul><ul><ul><li>On-site office visits to answer questions regarding the program and assist with completion of recruitment packets to be conducted by Doral Mequon and Virginia staff. </li></ul></ul>
  8. 8. Fall 2008 Provider Training Seminars <ul><li>Fall 2008 Provider Training Seminars conducted October 21 -24, 2008: </li></ul><ul><ul><li>Bristol  Springfield </li></ul></ul><ul><ul><li>Roanoke  Richmond </li></ul></ul><ul><ul><li>Charlottesville  Chesapeake </li></ul></ul><ul><li>Two (2) Free Continuing Education Units (CEUs) were offered to dentists and hygienists participating in the SFC program: </li></ul><ul><ul><li>Program Coverage Guidelines for Scaling and Root Planning – Presented by Dr. James Thommes, Senior Dental Director – Doral Dental </li></ul></ul><ul><ul><li>Dental Records – Guidelines for Adequate Chart Documentation – Presented by Cheryl Harris, Virginia Project Director – Doral Dental </li></ul></ul><ul><li>A total of 157 attendees participated in the 6 sessions. </li></ul>
  9. 9. Protective Stabilization Policy <ul><li>At the April 11, 2008 DAC Meeting, Doral recommended the adoption and adherence to the current guidelines for protective stabilization established by the American Academy of Pediatric Dentistry (AAPD) Guideline on Behavior Guidance for the Pediatric Dental Patient . </li></ul><ul><li>The proposed policy requires participating providers to confirm completion of training in the use of protective stabilization techniques. </li></ul><ul><li>The policy was placed on hold pending further discussion to determine if this policy will apply to Smiles For Children providers . </li></ul>
  10. 10. Thank You!