The Iowa Health and Wellness Plan (IHAWP), implemented on January 1, 2014, expanded health care benefits to low-income Iowans with incomes below 133% of the Federal Poverty Level who were not previously eligible for Medicaid. Beginning in May 2014, dental benefits were provided to IHAWP members through the Dental Wellness Plan (DWP). Originally, DWP (or, DWP 1.0) included a unique earned benefits structure to encourage healthy behaviors, including routine preventive dental care. At enrollment, members were only eligible for a core set of dental benefits, and could earn and maintain additional benefits by returning for regular recall exams every 6-12 months.
In May 2017, the Iowa Medicaid Enterprise proposed a change to the DWP scope and structure which became effective July 1, 2017. Through this amendment, the DWP (called DWP 2.0) was redesigned as an integrated dental program for all Medicaid enrollees over age 18. Prior to this change, individuals eligible through IHAWP were enrolled in the original DWP whereas all other Medicaid-enrolled adults received dental benefits via the traditional, fee-for-service delivery system. This unified dental program is intended to ensure continuity of care as members transition between Medicaid eligibility categories.
In addition to broadening enrollment to include low-income adults from both programs, the DWP 2.0 also modified the earned benefit structure. Members now have comprehensive dental benefits for the first year of enrollment, and must complete two healthy behaviors annually in order to maintain comprehensive coverage in subsequent years. Healthy behaviors include a preventive visit and completion of an oral health self-risk assessment. Members who do not complete these healthy behaviors will be assessed a $3/month premium, and those who do not pay the premium will be reduced to emergency dental coverage only.
The PPC will evaluate utilization and performance measures in DWP 2.0; comparisons will be made between DWP 2.0 and DWP 1.0 where appropriate. Major components of this evaluation include:
- Member perceptions of care and satisfaction with DWP 2.0 evaluated using mailed and online surveys.
- Dentist perceptions of, and participation in, DWP 2.0, evaluated using online surveys.
- Dental safety net capacity, assessed using online surveys of community health centers in Iowa.
- Provider network evaluations, examining geographical variation in dentist availability for DWP 2.0.
- Outcomes of care, including in-office and emergency department utilization of dental services, analyzed using enrollment and claims data for members of DWP 2.0.
All results of this evaluation will be posted on this website as they are completed and ready for release.