This presentation describes findings from work conducted by the National Academy for State Health Policy for MACPAC on monitoring and oversight of Medicaid managed care for children’s oral health services. Findings are based on a review of state policy documents and interviews with states officials, representatives of MCOs and dental contractors, and other stakeholders.
The presentation describes key monitoring and oversight approaches for provider network adequacy, use for preventive dental care and follow care visits, grievances and appeals, other monitoring tools, enforcement actions, and other levers states can use to drive improvements in children’s oral health. The presentation raises questions about the effectiveness of monitoring and oversight approaches, whether changes to those approaches are needed, and whether other structures or levers would be more effective in improving children’s oral health.