The University of Iowa serves as the independent evaluator for Iowa's 1115 Medicaid Waiver: Iowa Health and Wellness Plan (IHAWP). IHAWP is Iowa’s version of the Medicaid expansion, with the intent of providing comprehensive health care coverage to low-income adults who were not previously eligible for Medicaid (e.g., low-income single adults).
IHAWP members receive dental benefits through the Dental Wellness Plan (DWP). The DWP program is relevant to the IHAWP evaluation as the IHAWP program includes a healthy behavior incentive (HBI) component where most IHAWP members are required to receive an annual exam (medical or dental) and a health risk assessment (HRA) or pay a premium to stay enrolled.
This report presents results from a mailed survey of a simple random sample 10,000 IHAWP members about their experiences in DWP, specifically focusing on access to dental services and HBI among IHAWP members. This research is part of a broader evaluation of the IHAWP being conducted by investigators at The University of Iowa for the U.S. Department of Health and Human Services, Center for Medicare and Medicaid Services at the request of the Iowa Department of Health and Human Services
Key Findings
- Barriers to Receiving Dental Wellness Exams: 64% of IHAWP respondents who tried to find a dentist reported difficulty in finding a dentist who accepts Iowa Medicaid DWP, regardless of length of enrollment.
- Regular Source of Care: Only 47% of respondents reported having a regular dentist. Among those, a higher proportion of long-term enrollees (77%) reported that their regular dentist accepts DWP insurance compared to short-term enrollees (60%).
- Timeliness of Dental Care: 44% of respondents reported receiving dental care as soon as they wanted, while 38% reported delays, and 19% were unable to obtain dental care when needed.
- Emergency Dental Care: 14% of respondents reported needing emergency dental care. Of those, 45% were not able to be seen by a dentist for their dental emergency. Additionally, 4% used hospital emergency rooms for dental problems, primarily due to difficulties in finding a dentist.
- Unmet Dental Needs: 32% reported an unmet need for dental care. Of those with an unmet need, the most common needed services were check-up/cleanings, extractions, and fillings.
- Dental Wellness Exams and Oral Health Status: Members who received a dental wellness exam in the past year were more likely to rate their oral health as excellent or very good (36%) compared to those who did not receive an exam (23%).