Opportunities for MassHealth ACOs to Improve Oral Health and Reduce Cost through Emergency Department Diversion

Tuesday, August 13, 2019
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Rachel Gershon, JD, MPH
Commonwealth Medicine
Enid Vélez, MPH
Commonwealth Medicine
Donna C. Jones, DMD, MPH
Commonwealth Medicine
Tami Ohler, PhD
Commonwealth Medicine
Hilary Deignan, JD, MEd
Commonwealth Medicine

Health law and policy experts with our Public & Private Health Solutions team collaborated with UMass Medical School colleagues in a report produced with funding and support from the Southern New England Practice Transformation Network through the Transforming Clinical Practice Initiative, an initiative of the Centers for Medicare and Medicaid Services. The report highlights ways that MassHealth ACOs can improve oral health for their members and reduce costs through emergency department diversion.

MassHealth, the Massachusetts Medicaid program plays a central role in how many Massachusetts residents access dental services in the state. But for many MassHealth members, the emergency department (ED), not the dental office, is where they seek dental care. MassHealth beneficiaries seeking dental services at the ED cost the program over $2.44 million in total in 2017. These members can receive the same or higher quality of services at dental offices at a lower cost to the MassHealth program.  Promising oral health diversion programs in Massachusetts may point the way forward.