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Each week we deliver news, information, and resources. Is there a focus you'd like to see? Share your insights with us at marketing@skygenusa.com. 

News from the week of December 9, 2024

• NADP report reveals overall decrease in dental benefits enrollment (Globe News Wire) –NADP’s recent report on dental benefits enrollment, shows a decline of 1% coverage from the previous year. Most of this decline was in Medicaid while Medicare Advantage and commercial PPO plans saw increases in enrollment.
• 1-on-1: ADA President Dr. Brett Kessler on the future of dentistry (Dr. Bicuspid) – A recent podcast featured ADA President’s thoughts on topics including insurance reimbursement and the need for practice models to adapt to changing demographics.
• With or without ACA repeal, ACA and Medicaid cuts are looming (JAMA Network) – Larry Levitt of KFF outlines potential cuts to Medicaid with potential cuts that shift financial responsibility to the states which could substantially increase the number of uninsured. KFF estimates that 23.8 million people are at risk of losing coverage.
• Private Medicare insurers pressed for details on added benefits (Bloomberg Law) – Bloomberg looks at CMS requirements for reporting on spending on supplemental benefits for Medicare Advantage plans.
• US seniors face greater affordability challenges, study finds (Fierce Healthcare) – Another report from the Commonwealth Fund highlights healthcare affordability challenges among older US adults compared to adults in other wealthy countries. One data point found at least 20% of older adults in the U.S., Australia, and Canada reported skipping needed dental care, compared to 5 percent or less of older adults in the Netherlands and Germany. 
• Oral germs in pregnant women linked to mental health symptoms (Dr. Bicuspid) – A recent study in BMJ Mental Health linked levels of certain oral bacteria to stress, anxiety and depression in pregnant women.

News from the week of December 2, 2024

• Top factors keeping dentists from treating more Medicaid patients (Becker's Dental) –The ADA’s Health Policy Institute is out with a new Medicaid dental report and upcoming Webinar based on surveys of Medicaid members and providers. Results include the top barriers to receiving and providing care in this market. Dentists report that reimbursement rates, cancelled appointments and payment denials were the top factors keeping them from treating more Medicaid patients.
• Top reasons why adult Medicaid beneficiaries skip the dentist (Becker's Dental) – In this same ADA report, Medicaid beneficiaries reported that a lack of provider access was the top reason preventing them from accessing the dentist.
• Exclusive: Dr. Marko Vujicic talks dental trends, including staffing shortages, spending and more (Dr. Bicuspid) – A recent Dr. Bicuspid podcast featuring the ADA’s Dr. Marko Vujicic delves into the current state of dentistry including barriers to care.
• Medicaid expansion is a red and blue state issue (KFF) – KFF looks at the current state of Medicaid expansions and where vulnerabilities exist to drops in federal funding. In fact, several states have “trigger” laws which would impact coverage if the federal match rate were to drop below 90%. KFF also has updated their Status of State Medicaid Expansion Decisions and Medicaid Work Requirements reports.
• Pennsylvania leader to reintroduce bill restoring Medicaid dental coverage (Becker's Dental) – In Pennsylvania, a proposal to reinstate more comprehensive Medicaid dental coverage for procedures including root canals, periodontal disease work and emergency exams has been developed. 
• Trump could boost Medicare Advantage—but cracks suggest reform may be coming (Fierce Healthcare) – In the aftermath of the election it was assumed that the new administration could be a boon for Medicare Advantage, however some experts say the path forward could be rocky. In addition, the Biden administration is pushing through new regulations dealing with marketing and prior authorizations.
• 10% of US Adults have dental debt: Report (Becker's Dental) –  A new report from the Commonwealth Fund looks at the consumer dental debt and points out that the high cost of care stops many from receiving oral care.

News from the week of november 18, 2024

• What administrative changes could be coming to Medicare, Medicaid with Dr. Oz leading CMS? (ABC News) – Reactions to the nomination of Dr. Mehmet Oz to lead CMS and the impact on Medicare and Medicaid programs are filtering in.
• Urban Institute: 4M could become uninsured if enhanced ADA subsidies end (Fierce Healthcare) – The Urban Institute reports 4 million people could become uninsured if enhanced ACA subsidies are ended. The largest drops are expected in states that have not expanded Medicaid and among young and middle aged adults, leading to possible increases in premiums for those who remain on ACA coverage.
• CMS allows 5 states to adopt multiyear continuous Medicaid eligibility for children (Healthcare Dive) – The Biden administration has approved waivers for five states to keep children continuously enrolled in Medicaid/CHIP for longer than the standard 12 month period.
• Medicaid managed care survey highlights barriers to VBC adoption (HC Innovation Group) – A recent survey of Medicaid managed care plans finds value based care models continue to face data sharing and provider participation hurdles.
• Unclear routines risk the oral health of older adults in nursing homes (Medical Xpress) – A Swedish study showed the importance of structured oral health routines and staff training to ensure proper oral health care of older adults in nursing homes.
• Online features simplifying eyewear procurement for seniors with mobility limitations (Healthcare Business Today) – An array of online solutions are helping seniors access eye care from online exams to virtual glasses try-on.

News from the week of november 11, 2024

• What Administrative Changes Can Trump Make to Medicaid? (KFF) – Recent articles highlight how the Trump administration could impact Medicaid, accelerate the privatization of Medicare and provide an opening to repeal the ACA.
• What Will Trump's Second Term Mean for Dentistry? (Dentistry IQ) – The new administration could impact M & A, water fluoridation, supply chain costs and insurance coverage for the dental industry. While Public health agencies like the NIH could see funding cuts and reorganizations.
• Trump, RFK Jr. and the Bombshell No One Sees Coming (Med City News) – This writer predicts the new administration may push the healthcare industry to integrate organic food, nutritional interventions and transform hospital systems into agricultural innovation hubs.
• 40% + of New Yorkers Face Major Barriers to Dental Services (Becker's Dental) – A recent survey found the top barriers to accessing dental services included cost, lack of dental insurance and issues finding a dentist that accepts their coverage.
• Survey: Kentucky Children's Dental Decay Rates Surpass National Average (University of Kentucky) – A recent University of Kentucky survey found dental decay rates for Kentucky children ages 2 through 5 are significantly higher than the national average. The study indicated that factors including geography, race, ethnicity and economic resources all contributed to higher levels of tooth decay.
• ADA Study Eyes New Ways to Add Dental Benefits to Medicare (Becker's Dental) – A recent study published in The Journal of the American Dental Association proposes several options for adding adult dental benefits to Medicare.
• Integrating Coverage for People with Both Medicare and Medicaid (University of Pennsylvania) – A recent article makes the case for improving coordination for dual eligible coverage of supplemental benefits including dental and vision, better transparency about these benefits and monitoring of members usage of benefits.
• Dentists Are Dropping Payers: Here's Why (Becker's Dental) – Dentists say low reimbursements, lack of transparency and administrative burdens are prompting them to drop out of payer networks..

News from the week of november 4, 2024

• Insurers prep for Trump admin friendly to Medicare Advantage and mergers, hostile to Medicaid and ACA (Fierce Healthcare) – The new administration is expected to boost Medicare Advantage and healthcare mergers while bringing cuts to traditional Medicare, Medicaid/CHIP and ACA plans and potentially pushing to remove fluoridation from the water supply.
• California voters pass measure to secure new dental funding: 6 notes (Becker's Dental) – 
  California voters approved a measure that will increase the Medi-Cal dental budget beginning in 2027 to support higher reimbursement rates for restorative and specialty services for adults as well as increasing funding for dental workforce development.
• CMS adds dental services to Medicare coverage list: 6 notes (Becker's Dental) – Becker’s reviews the key measures in CMS’ final rule expanding coverage for dental services linked to end-stage renal disease..
• Inflation's impact on dentistry: 6 notes (Becker's Dental) – Dentists report how rising costs for wages and overhead have impacted different areas of their practices
• 10 things to know about DSO consolidation in 2024 (Becker's Dental) – Although DSOs have seen nearly 200 transactions in 2024, they report increased competition and growth challenges.

News from the week of october 28, 2024

• The 2024 State of America's Oral Health and Wellness Report (Delta Dental) – This year’s State of America’s Oral Health and Wellness Report finds an increasing number of adults connect oral health with specific health conditions. In addition, dental insurance coverage levels have reached a 5 year high.

• Dental students more interested in private practice after graduation: Report (Becker's Dental) – A new survey of dental students finds a slight increase in those with a preference for entering private practice immediately after graduation.

• 50-State Medicaid Budget Survey Archives (KFF) – 
• Medicaid and CHIP Eligibility Expansion and Coverage Changes for Children Since the Start of the Pandemic (KFF) – 

• Follow the Money: How Medicaid Financing Works and What that Means for Proposals to Change it (KFF) – KFF wraps up October with several in-depth Medicaid reports that capture uncertainty among Medicaid directors in their annual budget survey due to the election and continuing fallout from pandemic era changes. A review of what’s changed for Medicaid programs for children over the past four years finds innovative programs in many states. Finally they lay out the state of Medicaid financing along with potential changes.

• Ten Things to Watch for 2025 ACA Open Enrollment (KFF).– Updates include more insurers participating in ACA marketplaces, DACA recipients will be able to sign up for 2025 plans and there are new network adequacy standards to meet.

• News from the week of october 21, 2024

• As Pandemic-Era Policies End, Medicaid Programs Focus on Enrollee Access and Reducing Health Disparities Amid Future Uncertainties (KFF) – KFF has published details from their annual Medicaid budget survey. Priorities include provider rates, benefits and managed care and key challenges are tied to uncertainty related to budgets and the election.
• Medicaid's Health Equity Problem Starts and Ends with Health-Related Social Need (HRSNs). Why are They Being Overlooked? (MedCity News) – A new report from the Commonwealth Fund reveals how payers can gather data on health related social needs to better tailor care to their members.
• PwC's 2024 US Healthcare Consumer Insights and Engagement Survey (PWC) – The survey finds healthcare cost and navigation problems continue to plague consumers but opportunities exist to engage consumers in preventive care and provide their preferred access points..
• Oral Health Venture Trends (CareQuest Innovation).– A new analysis looks at venture funding trends in the oral health segment.
• Attention to Detail: Links Between Attention-Deficit/Hyperactivity Disorder and Oral Health (CareQuest).– A survey suggests that adults with ADHD face more risks to their oral health than adults without ADHD and tended to rate their oral health lower than the general population..

News from the week of October 14, 2024

• Economic Outlook and Emerging issues in Dentistry (ADA HPI) – The ADA’s Health Policy Institute is out with their quarterly survey of dentists. One key note is 26% of dentists report having dropped some insurance networks this year. The primary reasons were reimbursement levels and administrative burdens.
• Pathway to Value (HealthScape Advisors) – A recent survey finds that payers and providers have an opportunity to take advantage of changes in the industry to build on a shared commitment to enhancing oral health to accelerate adoption of value based care in dental.
• PwC's 2024 US Healthcare Consumer Insights and Engagement Survey (PWC) – The survey finds healthcare cost and navigation problems continue to plague consumers but opportunities exist to engage consumers in preventive care and provide their preferred access points..
• Are Dental Practices out of Control in the US (Medical Express).– Recent opinions and letters in JAMA Internal Medicine present varying perspectives on the current state of US dental care all emphasizing the need for evidence-based practices and changes in economic models.
• What's in your Mouth may be Linked to Epilepsy (Dr. Bicuspid).– A recent study links the health of the oral microbiome to epilepsy.

News from the week of October 7, 2024

• National Trends in Dental Care Use, Dental Insurance Coverage and Cost Barriers (ADA HPI) – The ADA’s HPI is out with an updated national trends report covering dental visits, coverage levels and the impact of cost on access.

• Medicaid Reimbursement for Dental Care Services (ADA HPI) – A second ADA report details Medicaid fee for service dental reimbursement levels by state for both children and adults..
• 2024 Employer Health Benefits Survey Says (KFF) – A new KFF report finds family premiums for employer-sponsored health insurance have risen by 7% in 2024. Over the last five years the increase in premiums has roughly aligned with the rate of inflation.
• Many MA Beneficiaries have Dental, Vision or Hearing benefits, but Access Gaps Remain (Fierce Healthcare) – A new study finds that low-income Medicare Advantage beneficiaries with dental, vision or hearing benefits still face significant barriers to care.
• SKYGEN Research Report Reveals Dental and Vision Providers are Ready for Technological Transformation (Healthcare Business Today) – SKYGEN recently released its 2025 Pulse report which focuses on provider sentiment.025 Pulse report which focuses on provider sentiment.

News from the week of September 30, 2024

• Dental Medicaid Reimbursement Increase Goes into Effect in Florida: 4 Notes (Becker's Dental) – Florida’s “Live Healthy” legislation will raise Medicaid reimbursements for dentists, the first rate increase since 2012.
• Amid Medicaid 'Unwinding,' Many States Wind up Expanding (KFF Health News) – Although millions have lost Medicaid coverage through the unwinding process some of these losses have been offset by gains in coverage through expansions in states like North Carolina and South Dakota as well as expanded coverage expansions for pregnant women and children.
• Exclusive: Medicaid Insurers Can do More to Improve Maternal Health Access, HHS Report Says (Fierce Healthcare) –  A new report from the Department of Health and Human Services Office of Inspector General shows some states are missing opportunities to require Medicaid managed care organizations (MCOs) to improve maternal health access.
• Top 5 Things to Know about Women and Medicaid Ahead of the Election (KFF) – The outcome in the presidential election could have major consequence for women and Medicaid, particularly in relation to pregnancy and other reproductive health care concerns.
• New Guidance Released for Medicaid Coverage Requirements for Children: 5 Things to Know (Becker's Dental) – Guidance related to new Medicaid/CHIP coverage requirements for children include strategies and best practices for dental compliance.
• Seniors' Dental Care Declines after Medicare Kicks in (MSN) – Researchers at Brigham and Women's Hospital detail worsening oral health among seniors primarily due to declines in preventive and other care due to cost concerns.
• ADA Releases Proposal on AI Algorithms in Dentistry (Becker's Dental) – The ADA has a new proposal setting standards for AI algorithms used in dentistry.

News from the week of September 23, 2024

• What is the Potential for Value-Based Care in Dentistry? (Healthcare Innovation) – A new survey assessing payer and provider perspectives on the transition to a VBC model in dentistry found legacy technology is one barrier to greater adoption.
• CMS Sets Medicaid Renewal Compliance Deadlines (Fierce Healthcare) – In the wake of Medicaid unwinding, CMS has released a notice requiring states to correct areas of renewal noncompliance by the end of 2026. CMS has noted widespread issues with compliance and notified 36 states in 2023 that mitigation strategies were required to avoid action from the agency.
• Providers Say Claims Denials are Increasing: Survey (Healthcare Dive) – A recent survey finds growing provider difficulty in managing claims denials. Prior authorizations and missing or inaccurate data were some of the leading reasons for claims denials. Providers also cited frequent changes to payer policies and growing concerns about getting paid by patients and payers.
• In Wake of Change Healthcare, CrowdStrike Outages, Health Systems Look to Diversity, Strengthen Supply Chain (Fierce Healthcare) –  Recent health system outages have brought cyber resiliency and the need for greater collaboration to the forefront for the healthcare industry.
• A Paradigm Shift for Agents and Brokers (Insurance Thought Leadership) – A recent interview discusses how automation for agents and brokers can free brokers to focus more individual attention and higher value interactions with their clients.

News from the week of September 16, 2024

• An Examination of Medicaid Renewal Outcomes and Enrollment Changes at the End of the Unwinding (KFF) – A KFF analysis provides key takeaways and possible policy changes as we near the end of the Medicaid unwinding process. A key finding concludes that nearly 10 million more people are currently enrolled in Medicaid/CHIP than at the start of the pandemic.
• The Healthcare Issues Keeping Employers up at Night (Fierce Healthcare) – A podcast looks at what health issues are at the top of mind for employers including employee wellness, various aspects of the cost of healthcare, health technology solutions and innovative benefit design. 
• State Health Data Organizations Grow More Sophisticated (Healthcare Innovation) – A recent white paper from Manatt looks at the development of state health data organizations (HDOs) which could inform policymaking and regulatory decision-making.   
• California's Data Exchange Framework Proves Government Can do Big Things (Healthcare Dive) –  California’s Health and Human Services secretary talks about efforts to strengthen health equity and streamline the exchange of heath information with a new Data Exchange Framework.
• Penn Dental Medicine Gets Grant to Improve Care for Patients with Disabilities (Becker's Dental) – Penn Dental has received funding improve care for patients with disabilities, in particular helping train in-home caregivers.
• Delayed Oral Health Care Due to Cost Among US Adults with Diabetes, 2018-2019 (JADA) – A new report looks at factors in delayed oral health care among people with diabetes. Key contributors to delayed oral health care included lack of coverage, low-income households and geography.

News from the week of September 9, 2024

• Medicare Adult Dental Coverage: A Novel Approach (JADA News) – A recent JADA article lays out a proposal for a hybrid Medicare adult dental benefit which would expand access beyond the current medically necessary coverage.
• What the Outcome of the Election Could Mean for Medicaid (KFF) – KFF analyzes major policy differences between the two presidential candidates that could impact Medicaid including ACA expansion, Medicaid financing, eligibility and more..
• KFF Health Tracking Poll September 2024: Harris v. Trump on Key Health Care Issues (KFF) – The latest KFF Health Tracking Poll finds that while the economy remains the top issue for many voters, health care concerns, including cost of care, are also important. 
• Medicare Advantage Quality Bonus Payments will Total at Least $11.8 Billion in 2024 (KFF) – As federal spending on Medicare Advantage bonus payments is set to decline 8% ($1 billion) in 20024, a new report examines bonus payment and enrollment trends. 
• Use of Dental Amalgam Restorations in the US Plummeted 80% (Healthcare Dive) – The use of dental amalgam restorations in the US has declined 80% overall since a fall 2020 FDA advisory recommended that high-risk individuals should avoid getting these types of fillings. 
• The Prevent Blindness 'Children's Vision Health Map" Provides New Data on Children's Vision and Eye Health Issues (Vision Monday) –  A new interactive map from Prevent Blindness hopes to help curb vision loss by promoting early detection and treatment of eye conditions such as amblyopia and strabismus through the presentation of county- and state-level characteristics that may impact children’s vision and eye health conditions and outcomes. 

News from the week of September 2, 2024

• More States Enact Dental Insurance Legislation (ADA News) – The ADA reports that Pennsylvania and Illinois recently passed legislation impacting rules on virtual credit cards, prior authorizations and medically necessary treatment for jaw injuries.
• StartUPDATES: New Developments from Healthcare Startups (MedCity News) – A startup is piloting their saliva testing program, which is designed to rapidly assess oral health risks in Snohomish County, Washington.
• Boom, Now Bust: Budget Cuts and Layoffs Take Hold in Public Health (KFF Health News) – The public health sector is dealing with budget cuts as COVID funding dries up, impacting their role as a safety net in many communities.
• Top of Mind for Top Health Systems 2024 (Center for Connected Medicine) – A recent survey on digital health technologies finds AI continues to be a focus with an emphasis on improving patient care and access and provider burnout..
• Uninsured, Less Educated Patients Less Likely to Question Medical Bills (Healthcare Dive) – A recent JAMA article showed that patients with lower levels of education and financial literacy as well as those without health insurance were less likely to contest medical bills.  
• Pressure Building on Medicare Advantage (Oliver Wyman)– A recent report tallies the challenges for Medicare Advantage this year including changes to the STAR program, lower risk adjustment levels as well as higher utilization. However, payers can take steps to weather the storm. 
• Medicare Agents Face Signs of Gloom (Think Advisor) – The changes in Medicare Advantage are also impacting brokers who will need support to better serve their constituents 
• CMS Commits $100M to Support ACA Navigators (Fierce Healthcare) – The Biden Administration is promising $100M to expand free support for people navigating healthcare.gov during the fall enrollment period for ACA, Medicaid and CHIP enrollment. 

News from the week of August 26, 2024

• The Vision Council Provider inSights Report Finds ECPs Experiencing Substantial Decreases Across All Areas of Practice Performance (Vision Monday) – A new report of eye care professionals shows decreases in revenue, staff retention and patient acquisition and retention.
• Beyond Cost, What Barriers to Health Care do Consumers Face? (Peterson-KFF) – According to KFF’s new analysis, many adults can face logistical barriers to care, like work schedules or finding a doctor in network.
• How DSO affiliation rates have changed in every state year-over-year (Becker's Dental) – Becker’s updates state level DSO affiliation rates with Nevada, Colorado and Georgia topping the list.  
• CMS has received 12K complaints of No Surprises noncompliance; won $1.7M in restitution (Healthcare Dive) –  Federal regulators received more than 12,000 complaints that insurers and providers weren’t complying with the No Surprises Act through the end of June.
• The Many Faces of UM: The Next Two Decades (Health Leaders Media) – Utilization management has long been held up as a means to improve the efficiency of health care services yet providers remain frustrated by bureaucratic requirements like prior authorizations.  
• 114k Kansans lost Medicaid coverage in post-pandemic ‘unwinding’ review - Kansas Reflector (Kansas Reflector) – Kansas reports that their Medicaid renewal process has improved greatly since unwinding began. The state appears to have a net increase of roughly 16,000 Medicaid members post COVID. 
• What a Harris-Walz ticket could mean for oral healthcare (Becker's Dental) Medicaid expansion slightly more likely under President Trump, analysts say (Fierce Healthcare) – As the presidential election nears, experts on chiming in on what we could see from a new administration. Experts are bullish on the impact a Harris Walz administration could have on oral health expansion and say a Trump administration could expand Medicaid due to a preference for work requirements. 
• Trickle-up Innovation: The Unexpected Benefits of Designing Healthcare from the Bottom Up (MedCity News) –  A health strategist asks what would happen if we placed the needs of the most vulnerable at the heart of healthcare innovation? 

News from the week of August 19, 2024

• PRACTICE MODALITIES AMONG U.S. DENTISTS (ADA HPI) – The ADA’s HPI has released 2023 dental practice model data. The report examines dentist affiliations broken down by practice size, DSO affiliation, dentist career stage, sex, and dental specialty. 
• HOW DID MEDICAID RENEWAL OUTCOMES CHANGE DURING THE UNWINDING? (KFF) – KFF digs into Medicaid unwinding disenrollment rates as of April 2024 and finds that while Medicaid enrollment declined by more than 13 million from its peak it was still roughly 14% higher than pre-pandemic levels. In addition, they found great variability by state.
   
• A LOOK AT VARIATION IN MEDICAID SPENDING PER ENROLLEE BY GROUP AND ACROSS STATES (KFF) – KFF digs into Medicaid unwinding disenrollment rates as of April 2024 and finds that while Medicaid enrollment declined by more than 13 million from its peak it was still roughly 14% higher than pre-pandemic levels. In addition, they found great variability by state
   
• MEDICAID OVERTAKES MEDICARE ADVANTAGE AS HEALTH INSURERS’ BOGEYMAN IN Q2 (Healthcare Dive) – Insurers are seeing higher costs as states cut their Medicaid rolls of often healthier, younger people. 
   
• J.D. POWER: MA PLANS BEAT COMMERCIAL COVERAGE ON CONSUMER SATISFACTION (Fierce Healthcare) – A new study shows regional Medicare Advantage plans are outperforming commercial health plans in overall customer satisfaction particularly in helping members save time and money, higher levels of trust and product offerings and coverage.
   
• THE DIGITAL TRANSFORMATION INVESTMENTS PAYING OFF FOR HEALTH SYSTEMS (Becker's Dental) –  A new report finds health system leaders view digital transformation including virtual health and digital front doors such as portals, mobile apps and digital billing as key investments.
   
• ORAL HEALTH IN ALABAMA: UNVEILING THE BURDEN AND PATHWAYS TO IMPROVEMENT (Alabama Public Health) –  A new report from the Alabama Department of Public Health details the oral healthcare issues facing residents in the state.

News from the week of August 12, 2024

• MEDICARE ADVANTAGE IN 2024: ENROLLMENT UPDATE AND KEY TRENDS (KFF) & MEDICARE ADVANTAGE IN 2024: PREMIUMS, OUT-OF-POCKET LIMITS, SUPPLEMENTAL BENEFITS, AND PRIOR AUTHORIZATION (KFF) (Medical Xpress) –  KFF has updated 2024 Medicare advantage reports detailing premiums, enrollment trends and more. 54% of the eligible Medicare population is now enrolled in Medicare advantage plans with more than 6.6 million enrolled in special needs plans such as d-snps.
   
• MEDICAID VISION COVERAGE FOR ADULTS VARIES WIDELY BY STATE (Medical Xpress) –  Medicaid vision coverage for adults varies by state, with significant gaps in routine eye exams and eyeglasses coverage.
   
• SURVEY: OVER 70 PERCENT OF FQHCS FACE CRITICAL STAFF SHORTAGES (Healthcare Innovation) –  In 2024, more than 70 percent of community health centers (CHCs) reported primary care physician, nurse, or mental health professional shortages, according to a new Commonwealth Fund survey.
   
• MEDI-CAL’S DENTAL CARE GAP: GETTING A TOOTH PULLED IS EASY — MUCH HARDER TO GET AN IMPLANT (KFF Health News) – California’s Medi-Cal dental program suffers from low provider enrollment and lack of coverage for procedures such as implants.
   
• FIRST US STANDARD ON AI IN DENTISTRY AVAILABLE FOR COMMENT (ADA News) – The ADA has published a draft standard for AI in dentistry includes image analysis associated with machine learning and deep learning. 
   
• MEDICAID, MA HEADWINDS PRESSURE PAYERS IN Q2. HERE’S A LOOK AT HOW MAJOR COMPANIES FARED (Fierce Healthcare) – Fierce Healthcare is reporting on revenue challenges payers are facing in Medicare Advantage and Medicaid markets due to elevated medical loss ratios and funding cuts.
   
• THE FASTEST-GROWING DSOS IN 2024 (Becker's Dental) – Becker’s reports on the fastest-growing DSOs in the US based on percentage revenue growth.
   
• AI ROUNDUP ROUNDTABLE BY KYLE PATTON, ASSOCIATE EDITOR (DentalTown) – SKYGEN’s Dr. Larry Paul comments on AI in dentistry. 

News from the week of August 5, 2024

• TO HELP PEOPLE ON MEDICARE AND MEDICAID, WE MUST PAY PROVIDERS FOR INTEGRATING CARE (Penn LDI) – A recent conference at the University of Pennsylvania focused on the challenges of creating integrated care for dual eligible individuals. Policy changes, care needs and care integration were among the topics under discussion.


• UNINSURED RATE JUMPS TO 8.2% AMID MEDICAID UNWINDING: CDC (Healthcare Dive) – The CDC reports that the number of Americans without health insurance has grown to 27.1 million as many have lost Medicaid coverage.


• ACA MARKETPLACE ENROLLEES WILL SEE STEEP INCREASES IN PREMIUM PAYMENTS IN 2026 IF ENHANCED SUBSIDIES EXPIRE (KFF) – Without enhanced subsidies, ACA Marketplace enrollees in 12 states could see their premiums significantly increase, potentially doubling by 2026.


• STUDY PINPOINTS HIGH-NEED AREAS FOR ORAL HEALTH SERVICES IN NEW YORK (Medical Xpress) – A new report from the Center for Health Workforce Studies (CHWS) at the University at Albany's School of Public Health identified regions with the highest oral health needs as well as contributing factors.


• ARKANSAS DHS CHANGING MEDICAID DENTAL FROM MANAGED CARE TO FEE-FOR-SERVICE (Kark.com) – The Arkansas Department of Human Services is making changes to Medicaid dental services.


• REMOVE THE GHOSTS FROM HAUNTED PROVIDER DIRECTORIES: 5 THINGS PAYERS SHOULD KNOW (HIT Consultant) – Strategies to improve healthcare provider directories include removing outdated information and enhancing data accuracy and reliability.


• PRIVATE EQUITY AFFILIATION AMONG DENTISTS INCREASES (ADA News) – The percentage of dentists affiliated with private equity has nearly doubled over the course of six years, according to a paper released Aug. 5 by the ADA Health Policy Institute.


• HOW THE DENTAL INDUSTRY’S CONSOLIDATION WAVE IMPACTS NICHE PRACTICES (Dr. Bicuspid) – The dental industry’s consolidation wave offers niche practices opportunities and challenges, urging owners to plan transitions for optimal outcomes.


• MOUTH AND DENTAL CARE FOR PEOPLE WITH DEMENTIA OFTEN OVERLOOKED, STUDY FINDS (Medical Xpress) – A new study has found that home care services often overlook the health of their dementia patient’s mouth and teeth.

News from the week of July 29, 2024

• MORE US ADULTS FEEL DENTAL INSURANCE NECESSARY FOR OVERALL HEALTH: STUDY (Becker's Dental) – Delta Dental’s annual “State of America’s Oral Health and Wellness Report” reports a rise in preventive visits, increases in dental coverage and a better understanding of the role of oral health in overall wellness.


• MEDICAID WAIVER TRACKER: APPROVED AND PENDING SECTION 1115 WAIVERS BY STATE (KFF) – KFF has published an updated Medicaid waiver tracker including both approved and pending Section 1115 Waivers.


• ILLINOIS TO EXPAND MEDICAID TO ADDRESS ROOT CAUSES OF HEALTH INEQUALITIES (WGN 9 ) – Illinois is getting ready to significantly expand Medicaid, taking it beyond the traditional medical and prescriptions realms.


• PENN LDI/HEALTH AFFAIRS CONFERENCE EXPLORES DUAL-ELIGIBLES CARE INTEGRATION (Leonard Davis Institute) & THE LANDSCAPE OF MEDICARE AND MEDICAID COVERAGE ARRANGEMENTS FOR DUAL-ELIGIBLE INDIVIDUALS ACROSS STATES (KFF) – Penn LDI and Health Affairs recently sponsored a conference on dual eligible care integration and KFF has a new report exploring dual eligibility frameworks in different states.


• CMS NOW ACCEPTING ELECTRONIC MEDICARE DENTAL CLAIMS: 5 NOTES (Becker's Dental) – The Centers for Medicare & Medicaid Services began accepting and processing claims for Medicare dental services July 1.


• REPORT: HIGHER-RATED MA PLANS ARE LESS AVAILABLE IN VULNERABLE COUNTIES (MedCityNews) – A new study found that disadvantaged counties are less likely to have Medicare Advantage plans with 4.5 stars or higher and more likely to have plans with 3.5 stars or lower.


• CALIFORNIA TRIES BUT FAILS TO FIX A MAJOR MEDICARE LOOPHOLE FOR SENIORS (NPR) – Despite efforts, California fails to address a significant Medicare loophole affecting seniors.


• INFLATION REDUCTION ACT HEALTH INSURANCE SUBSIDIES: WHAT IS THEIR IMPACT AND WHAT WOULD HAPPEN IF THEY EXPIRE? (KFF) –The Inflation Reduction Act (IRA) extended health insurance subsidies, benefiting ACA Marketplace enrollees. If they expire, premiums may double in 12 states.


• HHS UNVEILS MAJOR REVAMP TO SHIFT HEALTH DATA, AI STRATEGY AND POLICY UNDER ONC (Fierce Healthcare) – The Department of Health and Human Services (HSS) has restructured the Office of National Coordinator for Health Information Technology (ONC) affecting technology, cybersecurity, data and artificial intelligence strategy.


• NADP CELEBRATES PASSAGE OF KEY DENTAL BENEFIT LEGISLATION ENHANCING TRANSPARENCY AND CONSUMER CHOICE (GlobeNewswire) – NADP celebrates dental benefit legislation, enhancing transparency and consumer choice for affordable, quality care.


• WHAT ARE THE CONSEQUENCES OF HEALTH CARE DEBT AMONG OLDER ADULTS? (KFF) – Health care debt affects older adults, leaving many exposed to serious health and financial consequences.

News from the week of July 22, 2024

• CMS’ PROGRESS ON ORAL HEALTH INITIATIVES: 6 NOTES (Becker's Dental) – The Centers for Medicare & Medicaid Services published its inaugural fact sheet detailing the advance of its oral health initiative including progress in Medicare oral health coverage, Medicaid dental advances and more. 


• OHIO PASSES BILL AIMED AT IMPROVING DENTAL INSURANCE, LICENSE PORTABILITY (ADA News) – Ohio lawmakers passed legislation that aims to improve dental insurance by addressing non-covered services rules and license portability through the dentist and hygienist compact. 


• PENNSYLVANIA GOVERNOR SIGNS DENTAL INSURANCE REFORM BILL (Becker's Dental) – Pennsylvania has a new law requiring dental insurers to offer dentists alternatives to receiving payment via credit card which carry fees. 


• WITH COSTS UP BY AS MUCH AS 98% SINCE 2010, CAN MEDICAID DENTAL PRACTICES IN TEXAS SURVIVE? (Texas Dentists for Medicaid Reform) – Medicaid dental practices in Texas face critical challenges due to rising costs, staffing shortages, and outdated fee schedules.


• WHAT’S ON DECK FOR M&A IN THE DENTAL INDUSTRY (Becker's Dental) – Mergers and acquisitions were a huge part of the dental and DSO space in 2023, but changing economic conditions have raised uncertainty for the industry. 


• WHAT THE MEDICARE QUALITY RATING CHANGE MEANS FOR HEALTHCARE COMPANIES — AND PATIENT HEALTH (MedCityNews) – CMS is reevaluating its Star Ratings. Not only do health plans stand to benefit from the new calculations — all healthcare companies and millions of patients will reap the rewards.


• CMS CRACKS DOWN ON ACA BROKERS TO PREVENT PLAN SWITCHING (Healthcare Dive) – The Centers for Medicare & Medicaid Services (CMS) is taking action to prevent unauthorized plan switching by Affordable Care Act (ACA) brokers, following consumer complaints.


• HEALTHCARE COSTS SET TO RISE BY AS MUCH AS 8% IN 2025: PWC (Fierce Healthcare) – A report from PWC predicts that healthcare costs will rise by 8% next year.


• USOFCARE REPORTS ON STATE POLICY TRENDS TO ADDRESS HEALTHCARE AFFORDABILITY (Healthcare Innovation) – Inflation and healthcare affordability are the top issues for 2024 presidential candidates to address, concludes USofCare based on its wrap-up of state legislative activity.


• 69% OF HEALTHCARE CONSUMERS WILL SWITCH PROVIDERS IF COMMUNICATIONS DON’T MEET EXPECTATIONS (HIT Consultant) – 69% of healthcare consumers switch providers if communications don’t meet expectations, prioritizing clear, timely interactions.


• HEALTHCARE STAKEHOLDERS ARE MOSTLY OPTIMISTIC ABOUT HTI-2 (HealthcareIT News) – Healthcare leaders are reacting to the recently proposed HTI-2 interoperability rule, with most seeing it as a way to improve health information exchange between providers, health agencies and payers, others see large gaps.

News from the week of July 15, 2024

• NEW SURVEY FINDS OVERWHELMING MAJORITY OF U.S. VOTERS SUPPORT MEDICARE DENTAL COVERAGE (Dentistry IQ) – A new survey reveals strong public support for Medicare dental coverage.


• WHY BERNIE SANDERS IS TARGETING ORAL HEALTH: ‘DENTAL CARE IN AMERICA IS IN CRISIS.' (USA Today) – Sen. Bernie Sanders is promoting legislation to expand dental coverage and access through Medicare, Medicaid, and the VA.


• CMS PROPOSES EXPANDING DENTAL SERVICES ELIGIBLE FOR FEE-FOR-SERVICE MEDICARE PAYMENTS (Becker's Dental) – CMS released several proposals July 10 related to Medicare payments and claims submissions for dental services.


• COURT PAUSES CMS BROKER COMPENSATION RULE FOR MEDICARE ADVANTAGE PLANS (Fierce Healthcare) – A judge has paused CMS’s final rule on broker compensation for Medicare Advantage (MA) plans.


• SENATORS INTRODUCE BILL TO HELP EXPAND DENTIST PIPELINES (Becker's Dental) – A new Senate bill would provide grant money to create and expand dental provider pipelines, prioritizing programs in underserved areas and recruiting instate students.


• CROSSING THE DIGITAL DIVIDE TO SERVE MEDICAID POPULATIONS (HIT Consultant) – Studies find that Medicaid populations have access to cell phones and other personal technology, so efforts to bridge the digital divide should focus on related challenges such as health literacy, trust in the medical system, and reimbursement. 


• JUDGE DENIES REQUEST TO EXTENDED TIMEFRAME FOR GEORGIA’S NEW MEDICAID PLAN (FOX5 Atlanta) – A federal judge has denied a request to extend Georgia’s Medicaid alternative that launched a year ago. The program has enrolled fewer than 4,500 people, well below enrollment estimates.


• SENATORS INTRODUCE BIPARTISAN HEALTHCARE CYBERSECURITY LEGISLATION (Healthcare Dive) – The bill would create a special liaison within the Cybersecurity and Infrastructure Security Agency to help coordinate the government’s response during cyber incidents.


• DENTAL PROBLEMS AFFECT EVERY DAY FOR THESE PATIENTS (Dr. Bicuspid) – A recent study highlights the need for policy reforms and interventions aimed at improving dental care access to mitigate the detrimental effects of poor oral health on daily functions for vulnerable populations.

News from the week of July 8, 2024

• ECONOMIC OUTLOOK AND CHALLENGES IN DENTISTRY (ADA HPI) – The ADA’s HPI is out with their Q2 Economic Outlook and dentists are reporting that their top three challenges are workforce issues, insurance reimbursement including delayed and denied payments and increasing overhead/expenses. In addition, more than a quarter of dentists say they may drop insurance networks in 2024.


• RHODE ISLAND AND LOUISIANA PASS DENTAL LOSS RATIO BILLS (ADA News) – Rhode Island and Louisiana have passed dental loss ratio bills.


• HOW MISSOURI IS GETTING MORE PEOPLE TO THE DENTIST — FOR MORE THAN A PRETTY SMILE (The Beacon) – This month Missouri added routine dental exams to their adult Medicaid program, previously only cleanings were covered. Advocates hope it will be a big step in improving oral health and overall health.


• DENTAL VISITS FOUND TO INCREASE WITH SUPPORT FROM PEDIATRIC PROVIDERS (Medical Xpress) – A new study finds that children’s dental visits increased when pediatricians were trained to discuss oral health and provide dental referrals during annual medical checkups.


• HHS PROPOSES PHYSICIAN PAYMENT RULE TO DRIVE WHOLE-PERSON CARE AND IMPROVE HEALTH QUALITY FOR ALL INDIVIDUALS WITH MEDICARE (CMS) – CMS’s proposed (and controversial) Medicare physician payment rule includes notes on further exploration of expanding payment policies for dental services related to diabetes care and autoimmune diseases.


• STATES EXPERIENCE MEDICAID WINS (ADA News) – The ADA provides a wrap-up of recent state level Medicaid dental legislative changes.

News from the week of June 24, 2024

• LOWER-INCOME FAMILIES SPEND 7 TIMES MORE ON DENTAL CARE: REPORT (Becker's Dental) – A new report reveals lower-income families paid 7.4 times more in out-of-pocket costs for dental care compared to higher-income families between 2007 and 2021 and were less likely to visit the dentist.


• ‘I WAS EXPECTING EVERYBODY TO COME BACK AFTER COVID’: WHY STAFFING SHORTAGES HAVE DENTISTS SCRATCHING THEIR HEADS (Becker's Dental) – Dentists continue to grapple with staffing shortages and dental hygienists and assistants are being heavily recruited by competing practices offering higher wages.


• THE GROWING THREAT DENTISTS MAY NOT BE PREPARED FOR (Becker’s Dental) – General dentists may not be prepared for a cybersecurity incident as the possibility of these attacks grows, according to Huzefa Kapadia, DDS.


• RESEARCHERS LINK TOOTH LOSS TO INCREASED OBESITY RISK (Medical Xpress) HOW ALLERGIES MAY BUILD THE DENTAL-MEDICAL CONNECTION (Dr. Bicuspid) – Researchers have presented a new study linking tooth loss to obesity as well as recommendations for patient education. In addition, Oral mucosal immunotherapy (specially formulated toothpaste) is showing promise as a way to improve food and environmental allergies and may provide a method to strengthen the dental-medical connection among providers.


• STATES ADOPTED CHANGES TO EXPAND MEDICAID ELIGIBILITY AND STREAMLINE RENEWAL PROCESSES THAT WILL CONTINUE BEYOND THE UNWINDING, THOUGH CHALLENGES REMAIN (KFF) – The unwinding of Medicaid continuous enrollment provisions has led to changes that will extend beyond the current period. In addition, some states are facing challenges in maintaining coverage for seniors and people with disabilities due to cumbersome eligibility and renewal policies. 


• MEDICAID FOR MILLIONS IN AMERICA HINGES ON DELOITTE-RUN SYSTEMS PLAGUED BY ERRORS (KFF Health News) – Deloitte’s Medicaid eligibility systems have widespread problems that affect vulnerable populations. 


• 600K DROPPED FROM MEDICAID; HALF ARE CHILDREN (State Affairs) – Georgia is experiencing administrative challenges in managing the “Medicaid unwinding” process and researchers warn that a higher percentage of children are losing coverage in Georgia than in other states. Streamlined processes and improved communication could help alleviate some of these challenges.


• FIVE STEPS FOR MEDICARE SUPPLEMENTAL BENEFITS PAYERS TO HELP REPORT FEDERAL DATA (PWC) – Earlier this year, the Centers for Medicare and Medicaid Services (CMS) upended data reporting for payers who provide supplemental benefits such as vision and dental supplements to government-provided Medicare. PWC offers five recommendations to maintain compliance with these government mandates.


• FOR VM'S 2024 TOP 50 U.S. OPTICAL RETAILERS, REVENUES SHOW HEALTHY GROWTH DESPITE ECONOMIC UNCERTAINTY (Vision Monday) – The collective sales of Vision Monday’s Top 50 U.S. Optical Retailers rose 8 percent in 2023 compared with 2022, reaching an estimated $20.1 billion from 16,369 locations.

News from the week of June 17, 2024

• COST OF DENTAL SERVICES UP 5% FROM 2023: 4 NOTES (Becker's Dental) – The cost of dental services has increased by 5.1% over the last year, and the report shows a 1% increase since April.


• AMERICAN MEDICAL ASSOCIATION ADOPTS POLICY IN SUPPORT OF EXPANDED DENTAL BENEFITS (Becker's Dental) – The American Medical Association recently adopted a policy to support expanding dental coverage under Medicare, Medicaid, and CHIP, aiming to improve access to dental care for patients.


• PATIENTS RECEPTIVE TO NUTRITIONAL COUNSELING AT THE DENTIST (Dr. Bicuspid) – According to a study published in BDJ Open, dental patients are open to receiving diet advice in dental settings and are willing to follow nutritional programs to prevent both oral and systemic diseases.


• STATES ENACT DENTAL BENEFIT LEGISLATION (ADA News) – Sixteen new dental benefit laws have been enacted in nine states, addressing issues like assignment of benefits, claims review transparency, downcoding, and bundling. These reforms aim to improve dental care access and insurer practices.


• A LOOK AT MEDICAID AND CHIP ELIGIBILITY, ENROLLMENT, AND RENEWAL POLICIES DURING THE UNWINDING OF CONTINUOUS ENROLLMENT AND BEYOND (KFF) – KFF reports on efforts states have made to improve the Medicaid renewal process, strengthen benefits and improve communication and engagement.


• A TALE OF TWO STATES: ARIZONA AND FLORIDA DIVERGE ON HOW TO EXPAND KIDS’ HEALTH INSURANCE (KFF) –  Legislatures in Florida and Arizona worked across party lines in 2023 to pass bills expanding their states’ Children’s Health Insurance Program (CHIP).


• CMS RECALCULATES MEDICARE ADVANTAGE STAR RATINGS IN MAJOR WIN FOR INSURERS (Healthcare Dive) – The CMS has recalculated plans’ quality ratings in the Medicare Advantage program after a series of court rulings challenging the agency’s methodology in determining scores for 2024.


• UNINSURED RATE EXPECTED TO HIT 8.9% OVER NEXT DECADE, CBO FINDS (Healthcare Dive) – According to the Congressional Budget Office (CBO), federal subsidies for health insurance are projected to grow substantially from $1.8 trillion in 2023 to $3.3 trillion in 2033, reaching 8.3% of GDP.


• VIRTUAL SECOND OPINIONS SAVE OVER $8,700 PER PATIENT, NEW ANALYSIS FINDS (Healthcare Business Today) – A new quantitative case analysis from The Clinic by Cleveland Clinic reveals that virtual second opinions (VSOs) produce an average savings of $8,705 per patient.

News from the week of June 10, 2024

• UPDATE ON NET INCOME OF GENERAL PRACTITIONER DENTISTS (ADA  HPI) U.S. DENTIST RETIREMENT AND CAREER SPAN TRENDS (ADA  HPI) – The ADA’s Health Policy Institute provides net income statistics for general practitioner dentists in 2023 which vary based on factors such as location, practice type, and years of experience. A second report looks at retirement trends among dentists.


• U.S. NEEDS NEARLY 1,000 DENTAL PROFESSIONALS TO FILL SHORTAGE AREAS (Becker's Dental) – A new report from the Health Resources and Services Administration (HRSA) details dental shortage areas across all 50 states.


• MA BENEFICIARIES SPEND $2,500 LESS ON HEALTHCARE THAN TRADITIONAL MEDICARE BENEFICIARIES (MedCity News) – A new report finds Medicare Advantage beneficiaries spend less on healthcare than traditional Medicare patients.


• CMS PROJECTS NATIONAL HEALTH SPENDING GREW 7.5% IN 2023 TO $4.8T (Fierce Healthcare) – CMS projected that national health spending in the United States grew by 7.5% in 2023, outpacing the rest of the economy. The increases are due in part to historic gains in health insurance coverage which reached 93.1% of the population during the pandemic.


• BIDEN ADMINISTRATION ANNOUNCES A PLAN FOR REMOVING MEDICAL DEBT FROM CREDIT REPORTS (NPR) – The new rule proposed by the Consumer Financial Protection Bureau (CFPB) aims to help people with medical debt by changing how credit scores consider medical bills, potentially improving credit access for millions of Americans.


• ADA PLEADS WITH SUPREME COURT FOR INSURANCE REFORM (ADA) – The American Dental Association (ADA) urgently appeals to the Supreme Court for insurance reform, citing unfair practices by insurance companies that impact dentists and patients.


• NADP PUSH FOR GREATER ACCESS TO DENTAL BENEFIT GAINING TRACTION IN CONGRESS (ForexTV) – The National Association of Dental Plans (NADP) is advocating for increased access to dental benefits, and their efforts are gaining traction in Congress. 


• TAKING ADVANTAGE OF THE OPPORTUNITY OF AI FOR PAYERS (McKinsey & Company) – Healthcare payers can leverage AI for cost savings, improved outcomes, and efficiency.


• SKYGEN INDUSTRY OUTLOOK: THE TIME FOR DENTAL AND VISION BENEFITS TRANSFORMATION IS NOW (SKYGEN) – SKYGEN's 2024 industry outlook. 

News from the week of June 3, 2024

• VARIATION IN USE OF DENTAL SERVICES BY CHILDREN AND ADULTS ENROLLED IN MEDICAID OR CHIP (KFF) – KFF discusses challenges including low usage rates and strategies to expand access to dental care in Medicaid among adults and children.


• HOW FAMILIES' MEDICAID UNWINDING EXPERIENCE CAN HELP US ADVANCE HEALTH EQUITY (Georgetown Center for Children and Families) – The impact of the unwinding process on Medicaid enrollment for children in California is discussed, focusing on administrative barriers and opportunities for improving future coverage renewal.


• ARKANSAS TO END MEDICAID MANAGED CARE DENTAL PROGRAM: 4 NOTES (Becker's Dental) – Details on Arkansas’ plan to move their Medicaid dental from a managed care program to fee-for-service.


• ADVOCATES ARGUE FOR MEDICARE TO COVER DENTAL HEALTH (Pagosa Daily Post) – Dentists nationwide urge Congress to include dental coverage in Medicare, emphasizing the need for better access and education to improve oral health for older Americans and people with disabilities.


• DSOS FOCUS ON SPECIALTY SERVICES: A NEW ERA OF DENTAL CARE (Group Dentistry Now) – Many DSOs are expanding their specialty service offerings to increase practice revenue.


• INSURANCE COVERAGE INFLUENCE FREQUENCY OF DENTAL VISITS BY OLDER ADULTS (BenefitsPro) – A new study digs into factors impacting frequency of dental visits among older adults including insurance coverage, health status, race and income. 


• NEW RESEARCH FROM VSP VISION CARE FINDS 54 PERCENT OF GEN Z EMPLOYEES REPORT DECLINING EYE HEALTH (Vision Monday) – New research by VSP Vision Care reveals that 82% of Gen Z employees are working longer hours, including nights and weekends, and 54% report worsening eye health due to excessive screen time.


• J.D. POWER STUDY REVEALS GROWING GAP IN COMMERCIAL HEALTH PLAN SATISFACTION (HIT Consultant) – The J.D. Power 2024 U.S. Commercial Member Health Plan Study reveals a significant satisfaction gap between different health insurance providers, emphasizing the impact of insurers on Americans’ overall healthcare experience.

News from the week of May 13, 2024

• NEW KFF HEALTH TRACKING POLL (KFF) – KFF is out with their most recent Health Tracking poll which looks at attitudes towards Medicaid, Medicare and more in light of the upcoming presidential elections.


• WHY MEDICAID’S ‘UNDERCOUNT’ PROBLEM COUNTS (KFF Health News) – Millions of people were unexpectedly removed from Medicaid after pandemic-era protections expired, and nearly 1 in 3 enrollees didn’t realize they were covered by the program. 


• MEDICAID ‘UNWINDING’ DECRIED AS BIASED AGAINST DISABLED PEOPLE (KFF Health News) – TThe article discusses how Medicaid’s recent eligibility reviews fell short in complying with federal law which dictates that states must ensure that people with disabilities have appropriate communication and support to navigate the often confusing Medicaid redetermination process.


• CALIFORNIA’S $12 BILLION MEDICAID MAKEOVER BANKS ON NONPROFITS’ BUY-IN (KFF Health News) – California’s Medicaid program is undergoing a $12 billion transformation that involves nonprofits and community health workers, aiming to provide social services alongside traditional health care for low-income residents.


• IT'S TIME TO END THE MEDICARE-MEDICAID MERRY-GO-ROUND (Leonard Davis Institute) – Conflicting rules between Medicare and Medicaid create administrative nightmares for patients, affecting nearly 13 million dually eligible Americans.


• MEDICARE ADVANTAGE RISK ASSESSMENTS DRIVING BILLIONS IN COSTS EACH YEAR (Fierce Healthcare) – Medicare Advantage risk assessments drive up costs, affecting 44.4% of beneficiaries and leading to increased coding intensity. Restricting their impact could save $4.5 billion to $12.3 billion annually.


• THE VITAL ROLE OF A UNIQUE ELECTRONIC DENTAL RECORD (EDR) IN PROVIDING COMPREHENSIVE HEALTH CARE (Dentistry IQ) – EDRs streamline charting, treatment planning, imaging, and communication among providers, enhancing modern dentistry practices.


• MARQUETTE DENTAL GRADS 1ST IN U.S. TO RECEIVE ‘PRIVILEGE DIPLOMAS' (Becker's Dental) – Marquette dental grads receive ‘privilege diplomas’, allowing immediate practice in Wisconsin after graduation.


• STUDY REVEALS LINK BETWEEN FOOD INSECURITY AND TOOTH LOSS (Dr. Bicuspid) – Food insecurity may be linked to tooth loss among adults aged 50 and older in the U.S., according to a recent study published in the Journal of Public Health Dentistry.


• TECHNOLOGY, TRANSPARENCY AND THE BOTTOM LINE: CONSIDERATIONS FOR THE SPECIALTY BENEFITS ECOSYSTEM (DOTmed) – Christine Tremblay of SKYGEN discuesses technology, transparency, and considerations for the specialty benefits space.