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Improving Access to Care Through Case Management

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Improving Access to Care Through Case Management

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“Many DentaQuest members have multiple health needs. Oftentimes, these individuals are more focused on addressing the more urgent health needs rather than scheduling their dental appointments and taking care of their oral health. That’s where we come in.” — Cheryl Denley, dental case supervisor, DentaQuest

It’s no secret that entry to oral well being care is an ongoing concern in our nation, with explicit emphasis drawn to it after final 12 months’s dialog round increasing Medicare to incorporate a dental profit. Lack of oral well being schooling, financial strain and a strained well being care system making an attempt to rebound from the height of COVID-19 have made it tougher than ever for people to prioritize their oral well being care.

Nearly 74 million Americans lack entry to dental protection — and that was earlier than COVID disrupted well being care methods. Barriers to protection exist in all places — from socioeconomic components, racial inequalities, or lack of transportation or insurance coverage. In reality, 75% of Americans say they’ve skilled limitations to accessing dental care, mostly citing the associated fee or lack of dental insurance coverage. That’s the place DentaQuest’s case administration staff steps in.

DentaQuest’s case administration program helps join members with the sources they should obtain optimum oral well being by means of one-on-one consultations. The staff works across the clock with high-risk members — comparable to people with mental or developmental disabilities (I/DD), affected by poor psychological well being or critical well being problems — to get them the care they want by connecting sufferers on to suppliers.

“It’s important that our members get the care they need from the right providers,” mentioned Cheryl Denley, dental case supervisor at DentaQuest. “Sometimes these members haven’t been to the dentist in over two years or have never had dental care in their life. My job is to make sure they are connected with the best resources available.”

DentaQuest lately teamed up with Partners Health Plan, a nonprofit managed care group serving people with I/DD and their caregivers, to enhance entry to oral well being care for his or her members. Since the organizations started collaborating, important progress has been made in securing dental look after PHP members with 63% of PHP members finishing a dental go to – greater than earlier years with out DentaQuest.

Recently, Cheryl oversaw a case for a member who, regardless of visiting the dentist bi-annually for cleanings and preventive care, was experiencing appreciable tooth decay and shedding enamel. Through screening conversations, it was decided that the member had no schooling on oral well being care and wasn’t brushing his enamel at residence between bi-annual visits. As a results of Cheryl’s laborious work, this member was in a position to receive a second opinion and obtain extractions and essential implants.

“The work we do in case management is so important and rewarding. It’s extremely rewarding to hear how our efforts positively impact our members and make a real difference in their oral and overall health,” says Cheryl.

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