The National Council on Disability released a preliminary report which found that offering dental care through Medicaid was cost-effective.

The National Council on Disability releases the results of a preliminary Medicaid study focused on the costs and return on costs of offering basic dental benefits to adults with intellectual and developmental (I/DD).

The report, Medicaid Oral Health Coverage for Adults with Intellectual & Developmental Disabilities (I/DD) – A Fiscal Analysis, showed the cost-effectiveness of adding basic dental benefits in the 12 states that currently do not offer them.

The report was commissioned to determine if the Centers for Medicare and Medicaid Services should require all state Medicaid agencies to implement Medicaid reimbursement and payment policies that promote access to dental care for adults with I/DD. 

Medicaid adult dental benefits vary widely by state, and limited research exists on how the Medicaid program should best address oral health disparities for adults with I/DD.

“Given that dental health is a predicate for general health, and general health is a predicate for employment, education, and community life, we want to offer policymakers insights into how they can help improve oral health outcomes for people with I/DD,” said Jim Brett, vice chair of NCD. “With over a quarter of a million adults with I/DD who receive Medicaid living in states with either emergency-only or no dental coverage,  and two-thirds of adults with I/DD on Medicaid living in states that have extensive benefits still not receiving basic dental care, this initial study begins an important examination of access barriers.”

The report found that of the 7.3 million adults with I/DD in America, nearly 4.5 million relied on Medicaid for health coverage. However, in 12 states, Medicaid does not include dental coverage for adults with I/DD, offering little besides limited waiver programs in 7 of the 12.

Because of the coverage gap, adults with I/DD often forgo preventative and routine dental care and only seek out care at much higher costs in case of an emergency. It also leaves the population more vulnerable to developing chronic health conditions.

The NCD estimates that federal and state governments would save $7.7 million annually beyond recovering the initial cost annually by expanding coverage and eliminating costly trips to the emergency room.

The report recommends that states who do not currently cover dental care should add dental benefits to adults with I/DD following the model of the states that do extend dental coverage as part of Medicaid.

The NCD also recommends funding programs that address other barriers to oral care, including educating the dental workforce on treating adults with I/DD, implementing programs to improve daily oral care provided by caregivers, and improving education and support for good oral hygiene for adults with I/DD.

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