Iowa Dental Wellness Plan: Evaluation of Baseline Provider Network

The Iowa Health and Wellness Plan (IHAWP) is an expansion of health care, allowed as part of the Affordable Care Act (ACA), primarily to single adults with incomes below 133% of the federal poverty level and not otherwise eligible for Medicaid. The dental care portion of the IHAWP is being provided through the Dental Wellness Plan (DWP), administered by Delta Dental of Iowa (DDIA). DDIA is responsible for developing a provider network and paying dentists for the care provided.

This report, part of an evaluation of the DWP program being conducted by the University of Iowa Public Policy Center (UI PPC), presents information about the initial dental provider network available to DWP members, with a comparison made to the network of dentists available to adults in the Medicaid State Plan, administered by the Iowa Department of Human Services.

Within this report, DWP providers are defined as “active” if they are accepting new patients, as per provider data from DDIA, while Medicaid providers are defined as active if they have had at least one Medicaid paid claim within a six month period. Slightly different definitions for providers were used because there was not consistent data available at the time of these analyses: 1) We were unable to ascertain, from the Medicaid program, a list of Medicaid providers who were accepting new patients, and, 2) due a lack of DWP claims data at the time of this report, we were unable to determine a list of DWP providers who had submitted at least one claim. Despite the use of slightly different definitions in our comparisons, we believe we are still able to compare the provider networks appropriately.

This baseline assessment of the DWP provider network is one component of the UI PPC’s evaluation of the DWP program. Future reports about the DWP program will present findings from surveys (of members and providers) and examine outcomes of the care provided to DWP members, based on analysis of administrative data.