The Dental Wellness Plan (DWP) provides dental benefits for members enrolled in the Iowa Health and Wellness Plan (IHAWP), Iowa’s version of the Medicaid expansion and was enacted through bi-partisan legislation to provide comprehensive health care coverage to low income adults. The DWP was implemented on May 1, 2014, and is administered by Delta Dental of Iowa. It has a unique earned benefits structure aimed at encouraging preventive health care-seeking behaviors. Enrollees earn additional covered services when they return for regular periodic recall exams every 6-12 months. The aim of this study was to examine the experiences of Iowa’s community health center (CHC) dental clinics during the first year of the Dental Wellness Plan (DWP). It is part of a broader evaluation of the DWP that includes provider adequacy, provider surveys, cost and outcomes.
In May 2015, online surveys were administered to directors of all CHC dental clinics in Iowa (n=14). Descriptive analyses were conducted for all survey questions. All results are presented unweighted; analyses were conducted using IBM SPSS Version 21. Results from this survey are compared with a previous survey of Iowa CHC dental directors conducted in 2013 when appropriate.
Clinics perceived an increased demand for dental care during previous 12 months - primarily from new adult patients - as well as a need for more dental staff of all types. A majority of clinics reported that their overall experience with the DWP was positive. However, clinics were split in their overall experiences with specific aspects of the program, such as the earned benefits structure and the PreViser risk assessment.
Clinics also perceived some DWP administrative-and patient-related issues as problematic, e.g. difficulty of eligibility determination, limited services covered and time spent on paperwork. Patients had broken appointments, complexity of dental treatment needs, complexity of medical history, and patient non-compliance with recommended treatment.
Some administrative issues were perceived to be worse in DWP compared to Medicaid, and some were perceived to be the same or better. However, most patient-related issues were perceived as the same in both DWP and Medicaid by a majority of respondents.