NEWS: (IRVINE, Calif.) LIBERTY Dental Plan has reviewed the recommendations of the Little Hoover Commission Report, released April 1, 2016, which recognized the need for innovative, comprehensive and collaborative action, along with a vote of confidence for the preventive oral health care model of Dental Managed Care (DMC) program.
“We appreciate the Commission’s recommendations and all those who participate in constructive efforts to improve oral health access and utilization, especially for Medi-Cal beneficiaries who represent the most vulnerable populations,” said Dr. Amir Neshat, President and CEO of LIBERTY. “While there is much work to be done, the report validates LIBERTY’s solution-based participation and experience in the Medi-Cal program. We look forward to continuing our work with the DHCS in administering and implementing the quality initiatives that we already have in place, validating many of the Commission’s recommendations.”
LIBERTY is a leading National Medicaid Dental Benefit manager based in California, including hundreds of resident team members that have a unique national expertise in several different aspects of Medicaid Dental programs. LIBERTY’s provider reimbursement model, fee-for-service, combined with the basic principles of traditional organized delivery systems, is a member-centric solution managed by 21st century technology.
In fact, the Little Hoover Commission Report validates LIBERTY’s best practices. For example, the Commission’s recommendation to expand the concepts of Washington State’s Access to Baby and Child Dentistry (ABCD) Program and Alameda County’s Healthy Kids, Healthy Teeth Program to more regions aligns with what LIBERTY is doing. LIBERTY has already implemented a Provider Training program for GMC in Sacramento that is akin to the ABCD Program and, like the Alameda County program, LIBERTY has, over the past decade administered a comprehensive coordination of care, systematic care management program through its Case Managers and Community Liaisons. Care management is a key component of several of the Commission’s recommendations that focus on preventive care.
The Commission also recommends that more Pediatricians be recruited and trained to apply fluoride treatment; proactively and as an industry leader, LIBERTY is already funding and collaborating with the Center for Oral Health and the SynerMed Medical IPA to train Pediatricians to apply fluoride varnish to children, educate parents about the importance of oral health and refer these children to a dental professional for follow-up as part of a well-child visit strategy. The goal is to bring every child into the continuum of care while establishing a seamless connection between medical and dental professionals.
Of course, a key component to success is in the Commission’s recommendation to implement a customer-focused program and improve relationships with dental providers. LIBERTY has been fully engaged with its providers and members for years, as they know that effective care is always local and personal. In fact, the LIBERTY Provider Relations team visits our providers’ offices routinely, provides in-office training and is available as direct relationship managers, if and when the providers need them. This level of service contributes to the reason that several dentists surveyed rated LIBERTY as “excellent” and helped GMC achieve 100% growth in utilization from 2010-2014, including 250% for children ages 0-3.
Dr. Neshat stated that “With over a decade of Medi-Cal experience in California, as well as experience in varied Medicaid programs in several states across the country, we urge the oral health stakeholder community to responsibly review the Commission’s recommendations, particularly recommendations that call for 66% utilization which, comparatively speaking, would be one of, if not the highest in the nation. Based upon our direct experience, we know that a gradual and sustainable increase in utilization, with consistent improvement, should be our collective goal and objective. Utilization has been and will be improved based upon continued and persistent member engagement.”
The report mentioned in-depth the administrative burdens of dental providers signing up to participate in the Denti-Cal program. As a stark contrast, LIBERTY network providers are supported with a quick application process, which is online and only 5 pages, with 85% of providers credentialed within 30 days and 95% within 45 days. LIBERTY also offers other key components that the Commission recommends, including program field representatives, a live-person resource center for member and provider questions and resolution, provider referrals and fee-for-service reimbursement at the Denti-Cal fee schedule for primary care providers, and more for specialty services. This fee-for-service reimbursement means that LIBERTY does not pass on any financial risk to providers; assumes the administrative burden of credentialing; and pays claims in a quick and efficient manner. LIBERTY’s local approach to provider relationship management is especially important in promoting access to safety net providers.
In LIBERTY’s experience, non-traditional delivery mechanisms are absolute requirements in order to meet the demand for dental services in Medicaid. Therefore, LIBERTY has implemented school-based preventive programs, establishing virtual dental homes and has been collaborating with national experts in implementing other virtual dental programs.
Dr. Neshat added, “Our nationwide Medicaid experience includes engaging local providers in our peer review committees and engaging local stakeholders and advocacy groups in our regional advisory boards. We believe health care policies are best developed locally and should be combined with 21st century technology to ensure that tax payer dollars are spent appropriately on health care.”
Mixed throughout the Commission’s report is advocacy for fluoride varnish and dental sealants as “Key Tools of Preventive Care” and LIBERTY is at the forefront of providing these services, as well as sponsoring and participating in comprehensive School Based Oral Health Programs where fluoride varnish and dental sealants can be applied to children that might otherwise not receive these services. LIBERTY has demonstrated its commitment to re-orientation of the oral health care system by sponsoring oral health related symposiums, where national, as well as local, dental and community experts share innovative ideas and solutions.
LIBERTY recognizes that unnecessary pre-authorizations and other administrative burdens adversely affect the access to care beneficiaries need, and are very inefficient. LIBERTY’s solution allows for real-time monitoring of claims, based on each provider’s practice patterns. This allows for the beneficiaries to receive the care they need in a very timely manner and does not negatively impact all providers, for the actions of a few. Fraud, waste and abuse are blocked and tackled aggressively by the application of LIBERTY’s data intelligence.
LIBERTY also applauds the Commission for recognizing that Dental Managed Care is a sustainable, preventive model that has worked in demographically-similar Texas and shown significant gains in the two of 58 California counties that have such a program. Dental Managed Care (DMC) plans guarantee timely access to care through contracted networks of providers, just like Covered California.
The Commission stated: “Though the Commission is not making recommendations to encourage the expansion of managed care within the state’s Denti-Cal program, the emphasis on prevention now to save money later is impressive. It also stands in contrast to the state’s current Denti-Cal fee-for-service system, which is stuck in a cycle of treating high-cost problems that it doesn’t prevent.”
“We look forward to working with all stakeholders and being accountable partners for improving access and quality of care for Denti-Cal families,” said Dr. Neshat. “We consistently promote collaborative and innovative ways to connect our members to a dental home. We believe oral health is critical to overall health. We are committed to ensuring that every one of our members receives the care they need and providers are fully supported in helping their patients.”
About LIBERTY Dental Plan:
LIBERTY Dental Plan specializes in commercial and government sponsored dental programs, providing services to managed care organizations, state governments, labor unions, large group employers, municipalities, and individuals. With a vast majority of its membership enrolled in government sponsored programs, LIBERTY is recognized as a specialist in administering dental care for Medicaid, SCHIP and Medicare beneficiaries. LIBERTY has a proven record of successfully increasing the utilization of quality dental care for multiple programs, ensuring that a larger portion of premiums are appropriated directly to care.
LIBERTY is also recognized as an industry leader in the area of Dental Disease Management. A member of The Care Continuum Alliance ( http://carecontinuum.org/ ), LIBERTY shares their commitment to promote high quality standards for and definitions of key components of wellness, disease, case management where appropriate, and care coordination programs as well as support services and materials.
More information: http://www.LIBERTYDentalPlan.com/.
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