A lack of dental insurance means a lack of oral health care (and an abundance of pain) for many people. Left untreated, dental issues can hurt job performance and exacerbate related medical problems, among other negative impacts.
When adult dental care was cut from South Carolina’s Medicaid program in 2009, Palmetto Health in Columbia, S.C., saw a rise in dental-related emergency department visits. But EDs are equipped to treat the pain, not the underlying problem.
“When you have dental pain, you've got to get to the root of the problem — literally,” says Charles D. Beaman Jr., Palmetto Health CEO. “Out of that came the idea of forming a more comprehensive approach to meet the needs of patients who had dental pain.”
In 2012 Palmetto Health and its partners in the Midlands Dental Initiative decided to provide exams, extractions, fillings and surgeries for the uninsured in need. The program redirected patients from the ED to privately contracted dental practices at no cost to the patient. Rather, Palmetto Health reimbursed providers at the Medicaid rate.
The number of patients referred by the program rose from 743 in 2012 to 1,281 in 2014, but the number of ED dental visits declined only slightly. In 2013, Palmetto Health's annual community needs assessment found that there remained a lack of dental care for families and high-risk populations.
Palmetto and its community partners decided to build on and augment the success of the Midlands Dental Initiative. To that end, in 2016 they created WellPartners, a dental and vision clinic that provides emergency and preventive dental care to uninsured area residents, helping earn the system an American Hospital Association NOVA Award.
“The Midlands Dental Initiative morphed into WellPartners,” says Vince Ford, Palmetto Health's chief community health services officer. “We now have a permanent home for dental care five days a week.”
The clinic operates in newly renovated space in the Richland County Health Department. A full-time dentist runs the dental segment of the clinic, and other dentists rotate through the facility. A part-time optometrist and volunteers operate the vision-related portion of the clinic, which is on a bus line and within walking distance of other facilities that serve as patient medical homes.
“We found dentists who were willing to see these patients for a Medicaid rate,” Beaman says. “If you're a dentist and you have two slots a week available, or three a month, you could be happy to do this as a community service and get some reimbursement for it.”
Funding for WellPartners came from several organizations, including BlueCross BlueShield of South Carolina and Richland County, which provided an in-kind donation for space and infrastructure. Palmetto Health provided $220,000 for services and $100,000 for infrastructure in 2016.
Other partners in the program include Lexington Medical Center, United Way of the Midlands, Richland County and the South Carolina Department of Health and Environmental Control.
As of October 2016, WellPartners reported that nearly $1.3 million worth of treatment had been performed at the clinic, which translates to more than 3,300 service hours from providers. Palmetto Health provided nearly 100 referrals from its emergency department.
“If you have dental pain and don’t have insurance or resources, Columbia, S.C., is a pretty good place to be,” Beaman says.
Similar programs can be established in other communities, Beaman says, “if you've got partners who are willing to invest and you can do it collectively. If everybody does their fair share, you'd be amazed at what can be done.”
Each year, the American Hospital Association honors up to five programs led by AHA member hospitals as “bright stars of the health care field” with the AHA NOVA Award. Winners are recognized for improving community health by looking beyond patients’ physical ailments, rooting out the economic and social barriers to care and collaborating with other community stakeholders. The AHA NOVA Award is directed and staffed by the AHA's Office of the Secretary. Visit www.aha.org/nova for more information.