Publications
 

Evaluation of Provider Network in the Iowa Dental Wellness Plan, 2014-2016

McKernan, S.; Pooley, M.; Ingleshwar, A.; Momany, E.; Damiano, P.
08/2017

Abstract

On January 1, 2014 Iowa implemented the Iowa Health and Wellness Plan (IHAWP), which expanded health coverage for low income Iowans. IHAWP replaced the previous IowaCare program, offering more covered services and a broader provider network; while reducing the number of Iowans covered. IowaCare provided coverage for Iowans not categorically eligible for Medicaid through any other program or waiver and with incomes not exceeding 200% FPL, while Medicaid provided coverage for a similar population but only up to 138% FPL. IowaCare did not provide coverage for dental care, except for emergencies with coverage limited to extractions at two locations in the state. An evaluation of the IowaCare program indicated that members had significant pent up demand for dental care and poor oral status.3 This evaluation, in part, led to the establishment of the Dental Wellness Plan (DWP). 

The DWP began offering dental benefits to members of the IHAWP program on May 1, 2014. This report evaluates provider network adequacy during the second year of DWP implementation – May 2015 through April 2016 – and makes comparisons with the Year 1 provider network. 

From May 2014 through July 2016, Delta Dental of Iowa was the sole dental carrier for the DWP. As of July 2016, MCNA Dental became the second carrier to join the DWP. Both dental carriers are required to offer the same benefits, however, each carrier maintains a separate network of dental providers. Since MCNA was not an active provider network during Year 2, it is excluded from this current evaluation.