G-2407-21921

The Missouri Coalition for Oral Health (MCOH) is a state coalition that is a returning partner and grantee to CareQuest Institute. The organization’s work has historically been focused on the reinstatement and protection of Medicaid adult dental benefits, however the organization received support in 2021 to partner with Enable Dental to being the design of a responsive, value-based payment systems for oral health care in Missouri. They are also a current Veterans Oral Health RFP grantee.

An APM for people with IDD will create systems change to increase access to care and reduce dental health disparities. By using select and actionable metrics, an APM will increase the focus on quality, increase dental team capacity to successfully provide preventive care and treatment for people with IDD, and increase person-centered dental care. Funding will allow MCOH and Enable Dental to further prepare and address the various challenges that arise in designing, implementing, monitoring, and evaluating an APM.

In phase one, a data dashboard was created to capture and exchange data, support care coordination inside and outside the practice, and monitor and generate reports on targeted metrics. Over 120 underserved dental patients with I/DD received dental services through teledentistry. A set of meaningful clinical, quality, and person-centered measures were developed and tested.

Currently, nearing the end of phase two, through the use of teledentistry and mobile dentistry, 201 underserved dental patients with IDD have received quality oral health care by three providers located across the state. A set of clinical, quality, and person-centered measures are being tested. This work includes real-time monitoring and evaluation. The data dashboard created and housed within Enable Dental during phase one does not accommodate data testing and analysis from external dental providers. It is important for a data system to be administered and housed within MCOH, the project grantee. A new data system, administered by MCOH, is being developed to analyze data, examine the impact of target measures on quality of care and access, as well as the applicability of such measures in an APM in Missouri. Mock incentive payments are being created for the three dental providers who meet specific aggregate performance thresholds on trial measures.

This work is complex and requires a second year of phase two to allow us to further educate and advocate for better coverage for the IDD population within Missouri. A new data system will continue to be developed, real-time monitoring and evaluation will continue, including making decisions about the methods, data, tools, and performance benchmarks that are used to monitor and evaluate the program to address refinement of the APM, and dental services to underserved individuals with IDD by the three providers will continue.

This request is for $226,239 which is 30% of the organization’s overall budget. The grant funds will support staff salaries and contracts with the three organizations providing dental services and partnering with MCOH on this work. Funding is recommended at $180,000, which is 24% of the organization’s overall budget. The decreased funding will reduce the amount allocated for staffing and indirect funds.