The Dental Safety Net in Iowa (DSNI) Project

The impact of the Affordable Care Act and other delivery system changes on the oral health safety net

The Patient Protection and Affordable Care Act (ACA) and other associated payment and delivery system changes could have a profound impact on access to health care services. The University of Iowa Public Policy Center (PPC) is currently working with The Commonwealth Fund (New York, NY) to evaluate the impact of the ACA on safety net providers and payers in Iowa. The DSNI Project is studying this impact on oral health care and the oral health safety net. This project, now in its second year, is supported by a demonstration grant from the DentaQuest Foundation (Boston, MA) to investigate ACA-related changes to the dental safety net in Iowa. This project aims to identify opportunities for handling those changes.

The ultimate goal of this activity is to inform policymakers in Iowa and nationally of the dental specific issues regarding the implementation of the ACA and to develop strategies to address dental needs in the near and distant future including opportunities for public/private partnerships.

Project Description
The study investigates the challenges likely to be faced by oral health providers in managing changes associated with ACA implementation, including Medicaid expansion.  To date, this project has:

  1. Examined the existing state of access to dental care in Iowa,
  2. Assessed capacity of the current public dental safety net providers, and
  3. Evaluated the level of private dentist participation in Medicaid and identified factors affecting their participation.

Activities that are underway will:

  1. Evaluate current gaps in the safety net system,
  2. Develop a primary care dental home model,
  3. And explore the role that the dental profession can play within new models of service provision, including ACOs.

A National Advisory Committee for the DSNI project operates as a subcommittee to the broader Commonwealth Fund supported safety net project and provides feedback at key steps throughout this project.