In June, the Louisiana Department of Health announced plans to implement coordinated care for Medicaid dental benefits. After months of dialogue with dental stakeholders about how best to coordinate this aspect of Medicaid recipients' care, LDH has finalized its dental reform concept, which contains many improvements based on this valuable feedback, and issued a Request for Proposals last week for the Medicaid Dental Benefit Program.
Through this competitive procurement process, LDH will select a single entity that will manage dental benefits for eligible Medicaid recipients as the Louisiana Medicaid Dental Benefit Program. This approach is a best practice that many other states with Medicaid managed care use to coordinate dental benefits.
The department issued its Request for Proposals to select the entity that will manage this program Dec. 18, with plans to proceed toward a March 1, 2013 go-live date for the new program.
Dental providers represent a critical component of the Medicaid health care delivery system, and LDH anticipates that having a single contractor responsible for management of the dental care for recipients will make providers' processes easier by having uniform requirements for prior authorization, claims filing and other business processes, minimizing the number of different procedures dental offices must negotiate to remain Medicaid providers.
One Louisiana Medicaid Dental Benefit Program will also ease access for recipients, and is expected to result in:
- Improved coordination of care
- Better dental health outcomes
- Increased quality of dental care as measured by metrics such as HEDIS and those being developed by the Dental Quality Alliance
- Improved access to essential specialty dental services
- Outreach and education to promote healthy dental behavior
- Increased personal responsibility and self-management
- A reduction in the rate of avoidable hospital or emergency department visits for routine dental care
- A decrease in fraud, abuse, and wasteful spending
- Greater accountability for the dollars spent
- A more financially sustainable system
- Net savings to the state compared to the existing legacy Medicaid delivery system.
LDH will give dental providers additional guidance as the Medicaid program progresses toward the March 1, 2013, go-live and the selection process is under way. Additionally, LDH will offer a series of statewide education and outreach sessions to give providers more information about the new, coordinated care approach to Medicaid dental benefits, similar to the provider outreach that has occurred for other services moving to a coordinated care model through Bayou Health.
Medicaid program leadership welcome continued feedback from dental providers, recipients, advocates and other stakeholders throughout this process.
People are welcome to learn more about Medicaid managed care at www.MakingMedicaidBetter.com, and view information about the upcoming changes for dental services, which is on the "Providers" section under the heading "Dental Services." LDH will update the website frequently during this process.
The Dental Benefit Program Request for Proposals is available on this website, which includes a detailed terms and conditions of the requirements for a coordinated care network for dental services from entities to serve as a statewide Dental Benefit Program Manager. The public is advised to check here often to see the latest details.
Visitors to the site also can review information about Bayou Health, subscribe to LDH's newsletter for frequent email updates about the Medicaid program and submit questions or comments electronically. Stakeholders can also email their comments or questions to firstname.lastname@example.org. Typically, staff are able to provide an answer within one business day.