Date: 08/31/2006
Final
Benefits of Preventative Care
HEALTH CARE TASK FORCE
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10:12 AM - Benefits of Preventative Care
Dr. James Todd, Children's Hospital, began his testimony and distributed a number of handouts to the committee (Attachments A through C). He stated that over the last 20 years, there has been a decrease in the amount of children covered by private health insurance and that 14 percent of Colorado children did not have health insurance in 2003. Over the past several years, the number of patients that doctors have been able to see has declined because Medicaid reimbursement rates do not cover costs. He stated that Medicaid-eligible kids who are seen in unassigned fee-for-service arrangements are vaccinated less and have fewer primary care visits. Because of decreased reimbursement to physicians, 140,000 children in Colorado do not have primary care providers. This leads to poor health outcomes for children and increased costs for the state. He stated that money currently being spent on unnecessary hospitalizations could be spent on primary care.
10:22 AM
Dr. Robert M. Trombly, Colorado Dental Association, distributed a handout to the committee (Attachment D). He stated that tooth decay is one of the most common diseases of childhood. Children from families without dental insurance and medical insurance are more likely to have unmet dental health needs. Most dental health problems are preventable, but racial and ethnic disparities in dental problems exist. He discussed studies related to preventative dental care for children. Studies have show that lack of dental care leads to costly emergency room visits, sealants prevent cavities and associated dental costs, and fluoridation prevents dental treatment costs. Recent studies have outlined how to improve dental health care in Colorado.
10:33 AM
Shelby Kahl, Colorado Dental Hygienists Association, discussed a school-based dental health care clinic for children in Weld County. She stated that dental hygienists who treat children eligible for the Children's Basic Health Plan (CHP+) are not reimbursed for services under the program. She discussed cavities and their causes.
10:38 AM
Dr. Tillman Farley, Salud Family Health Centers, agreed with the other panelists regarding the importance in providing integrated medical and dental care. He discussed the importance of preventative care early in a person's life. He stated that persons with a medical home get more preventative care and have fewer emergency room visits. He suggested the committee review the evidence to determine which preventative health care practices are effective.
10:44 AM
Panel members responded to questions from the committee. Senator Keller asked what barriers exist to dental hygienists being reimbursed by CHP+ and for a description of the geographic area of Ms. Kahl's pilot program. Dr. Trombly responded to questions from Senator Stafford regarding why so few Medicaid patients have preventative dental visits. He responded that there are numerous reasons including a lack in the availability of providers and patient access to dental care. Dr. Trombly and Representative Stafford discussed collaborations between dentists and primary care physicians. Representative Butcher asked for Colorado-specific data regarding oral health and community fluoridation water programs. Representative Frangas asked what reimbursement rate would encourage dentists to participate in the Medicaid program, and Dr. Trombly responded that rates are currently too low to encourage participation and that the administrative burden of the program is high.