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Dental Public Health Activities: Descriptive Summaries

Enrolling Dental Hygienists as Medicaid Providers

Practice Number: 51007
Submitted By: Vermont Department of Health/Office of Oral Health
Submission Date: March 2019
Last Reviewed: March 2019
Last Updated: March 2019
Best Practice Approach Example Enrolling Dental Hygienists as Medicaid Providers

The Commissioners of the state Medicaid agency and Department of Health convened a workgroup to develop strategies to increase access to dental care for adult Medicaid beneficiaries and enrolling hygienists as Medicaid providers was one of the strategies identified by the workgroup.

Costs associated with this activity involve staff time and increased reimbursement costs incurred by the Medicaid program (as more Vermonters receive care). However, investment in preventive care and silver diamine fluoride may lead to lower overall costs to the program and the State over time (fewer Vermonters seeking dental care in emergency departments and using general assistance vouchers for dental pain).

The short-term outcome that has been achieved is that there are at least six new Medicaid providers in Vermont. Intermediate and long-term outcomes include increased access to dental care for adult Vermonters insured by Medicaid, reduction in emergency department visits and general assistance voucher use for dental related pain, and ultimately a reduction in dental health disparities.

The biggest lesson learned is that it’s important to develop a comprehensive packet of information early in the process that addresses all potential questions upfront so that you’re not responding to questions piecemeal as they come up. Any hygienist is able to apply to become a Medicaid provider, not just those working in public health settings.

Lessons Learned:

One important lesson learned that would be useful for others looking to implement a similar activity is to make a strong case for why this would be helpful for your state. A key aspect of this activity was the development of a comprehensive packet of information that addressed concerns and questions that came up throughout the process.

In retrospect, if we were to do anything differently it would have been to work with partners to develop the information packet sooner. It seemed like every time there was a meeting designed to decide whether or not to move forward with enrolling hygienists as providers in VT, more questions would come up that delayed the process. Compiling and addressing the questions earlier would have saved some time.

In addition to the challenge mentioned above, there was also turnover at DVHA that delayed the process (a new Commissioner was appointed).

Contact Person(s) for Inquiries:

Robin Miller, Oral Health Director, Vermont Department of Health/Office of Oral Health, 108 Chery St., PO Box 70, Burlington VT 05402, Phone: 802-863-7272, Email Address:  

Debora Teixeira, Program Manager, Vermont Department of Health/Office of Oral Health, Same as above, Phone: 802-652-4115, Email Address: