G-2403-20256

Virginia Health Catalyst (Catalyst) is the state oral health coalition of Virginia that works to ensure all Virginian’s have equitable access to comprehensive health care, including oral health, through specific strategies focused on public health, policy, public awareness, and clinical-community care partnerships. CareQuest Institute has partnered with Catalyst to support policy advocacy aimed at the expansion and implementation of Medicaid adult dental benefits as well as to position safety net clinics within Catalyst’s network for a move toward oral health value-based care. Catalyst has been working consistently to establish new, community-based, and state-level partnerships that continue to inform the organization’s approach to health equity work.

Within the past three years, the state of Virginia has expanded adult Medicaid dental benefits, increased Medicaid dental reimbursement rates, and dedicated funds from the American Rescue Plan (ARPA) to the safety net for investments in technology, infrastructure, and clinical staff time to test VBC innovations. Virginia is the only state using ARPA funds to support oral health innovations, which positions Catalyst to continue leading in the value-based care space. Catalyst’s proposal for 2024-25 focuses on sustaining their work with two dental safety net clinics in Virginia to pilot the use of dental diagnostic codes to enable care integration and improve provider communication. Catalyst will continue to support these clinics’ use of CDT and ICD-10 codes, which connect dental services to their related medical diagnoses, to increase use of these diagnostics codes will help to illustrate the persisting oral health needs for vulnerable, historically marginalized communities.

The pilot has highlighted an opportunity to meet patient needs by leveraging a shared electronic health record (EHR) that includes combined medical and dental records for the participating clinics. More specifically, communication between the care teams may be enhanced to benefit patients by using Z codes, which are diagnostics codes that document social determinants of health needs and can help providers better understand the individual patient experiences and encounters with the health care system. With CareQuest Institute grant funding, Catalyst will continue its technical support for its partner clinics, bring in additional experts for technological and educational improvements as needed, and prepare reports and resources to help other clinics replicate best practices. The pilot will highlight barriers and opportunities to inform potential policy and organizational changes that can further support integration.

This proposal is recommended for funding at the requested amount of $135,000, which is approximately 8% of the organization’s overall budget. The bulk of the recommended grant funds will go toward staff time and support eight project roles while the remaining grant funds will support meeting supplies, travel, and consulting (coordination and data collection related to the clinic teams at the VA Association of Free and Charitable Clinics & VA Community Health Care Association). Based on the scope of work, the project is aligned with CareQuest Institute’s strategic priorities and Health Transformation.