The Dental Wellness Plan (DWP) is the dental insurance plan for members enrolled in the Iowa Health and Wellness Plan (IHAWP), Iowa’s version of the Medicaid expansion. It 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 to encourage preventive health care-seeking behaviors. Members earn additional covered services when they return for regular periodic recall exams. The aim of this study was to evaluate DWP providers’ experiences with the program, as well as all dentists’ perceptions of the DWP.
Surveys were administered to all licensed Iowa general dentists and dental specialists in private practice as of March 1, 2015 (n=1383), regardless of DWP participation. 558 Iowa private practice dentists responded to the survey for a 43% response rate after adjusting for those who were ineligible. Among all respondents, 42% were currently accepting new DWP patients, 8% had previously accepted new DWP patients but were no longer doing so, 49% had never signed up for the program, and 2% had signed up but had never seen a DWP patient.
Dentists participated in DWP (Dental Wellness Program), particularly those private practitioners were more likely to be in the youngest and oldest cohorts and male. According to a majority of DWP participants, referral to dental specialists, intermittent eligibility, the limits on covered services and the time spent on paperwork were the biggest problems with DWP. Reimbursement rates and the scope of benefits were important barriers to DWP participation among non-participating dentists. The stability of the DWP provider panel could be a factor in the future although DWP participants were more likely to have favorable attitudes toward the DWP program compared to non-participants. DWP participants are more likely to also accept new Medicaid patients. DWP participants had mixed feelings about the earned benefits approach. More than three quarters said it makes it difficult to provide comprehensive care and that it prevents DWP patients from getting the care they need when they need it. Additionally, the majority believe that limits on covered services is a major problem in DWP. Reimbursement and the bonus pool program were major drivers of PreViser risk assessment utilization among the two thirds of DWP participants who use the assessment.
Based on the findings from the survey, policy recommendations were made to address the concerns identified by both DWP participants and non-participants.