HJAR Nov/Dec 2023

HEALTHCARE JOURNAL OF ARKANSAS I  NOV / DEC 2023 57 Sharon Lanier, PhD Executive Director Delta Dental of Arkansas Foundation care, enhanced quality of services, sustain- ability, support for preventive care, reduced uncompensated care costs, and improved collaboration with local health systems. The result: MoreArkansans would benefit fromquality dental care — a systemic change that could quite possibly elevate Arkansas’ oral health ranking from near bottom and create a more equitable healthcare system. n REFERENCES 1 National Association of Dental Plans. “(All States) Dental Benefits Fact Sheet.” Released 2023; accessed Sept. 22, 2023. https://knowl- edge 2 Arkansas Center for Health Improvement. “Utili- zation of Dental Care Among Arkansas Children and Adults.”June 2022. https://achi.net/wp-con- tent/uploads/2022/05/220524_ACHI_DDAF_ Dental_Utilization_Report_2022-FINAL-FOR- PRINT.pdf 3 Kaiser Family Foundation. “Dental Care Health Professional Shortage Areas (HPSAs).” As of September 30, 2022. https://www.kff.org/other/ state-indicator/dental-care-health-professional- shortage-areas-hpsas/?activeTab=map&current Timeframe=0&selectedDistributions=total-den- tal-care-hpsa-designations&selectedRows=%7B %22states%22:%7B%22arkansas%22:%7B%7D%7 D%7D&sortModel=%7B%22colId%22:%22Locatio n%22,%22sort%22:%22asc%22%7D 4 U.S. Department of Health and Human Ser- vices, National Institutes of Health, National In- stitute of Dental and Craniofacial Research. “Oral Health in America: Advances and Challenges.” 2021. https://www.nidcr.nih.gov/sites/default/ files/2021-12/Oral-Health-in-America-Advances- and-Challenges.pdf 5 Okunev, I.; Tranby, E.P.; Jacob, M.; et al. “The im- pact of underutilization of preventive dental care by adult Medicaid participants.” Journal of Public Health Dentistry. 82, no. 1 (Jan. 11, 2022): 88-89. DOI: 10.1111/jphd.12494. Sharon Lanier, PhD, is the executive director for the Delta Dental of Arkansas Foundation, where she unites institutional values with community invest- ments that help address oral health disparities and increase human well-being. She has almost two de- cades of experience in the public sector, focusing on philanthropic engagement, policy development, programevaluation,and cross-sector collaboration. Lanier holds a bachelor’s degree in communication,a master’s degree in psychology,and a PhD in interdis- ciplinary leadership studies. She is amember of the Oral Health Coalition and sits on multiple nonprofit boards and community-driven commissions. of the provider credentialing process, insurance verification, claim submis- sion, and compliance and regula- tory requirements. Because they are stretched so thin with high demands for their services, they may even lack the time and energy to explore creative, innovative ideas. • They serve patients who might lack proper identification or documenta- tion, making it challenging to meet the requirements of third-party payers. • They are worried that an expansion to third-party billing might divert from their mission of serving those in need. • And last but not least, they fear losing their 501(c)(3) status — a widespread misconception. In animated brainstorming sessions at the institute’s headquarters or in virtual calls, the clinics have addressed these and other concerns. As fellow practitioners, they are in an ideal situation to appreciate the charac- teristics of free dental clinics, share relevant resources and learn from each other to help increase capacity. Meanwhile, the Delta Dental of Arkan- sas Foundation staff has listened intently and gained new insights into how to sup- port community-driven, innovative efforts to increase the oral health of all Arkansans. The playbook is one of those innovative efforts. On track for completion by year’s end, it will provide a comprehensive guide that charitable dental clinics can use to imple- ment third-party billing. Billing insurance is not just a financial transaction for safety net clinics; it's a life- line that enables them to fulfill their mis- sion of providing high-quality healthcare to underserved communities. The benefits of billing insurance extend beyond financial stability, encompassing expanded access to health needs. They are typically located in areas where access to dental care is lim- ited, including rural and low-income urban communities. These clinics often rely heavily on funding from federal and state sources, grants, and community donations. While the support allows them to offer services at reduced or sliding-scale fees, many safety net clinics do not bill insurance, thus limiting treatment options and patient access to care. In 2023, the Delta Dental of Arkansas Foundation partnered with the Winthrop Rockefeller Institute to explore ideas on how safety net clinics could increase their capacity to serve more people. The institute received a strategic initiative grant to cre- ate a playbook detailing best practices for nonprofit dental clinics inArkansas to begin billing and accepting third-party payments for services, including Medicaid and private insurance. Since spring, the institute and the founda- tion have convened regular meetings with 11 charitable dental clinics from across the state plus subject matter experts such as lawyers, regulatory and licensing agents, and insurance billing specialists. Through this peer-to-peer learning, they have explored the challenges and opportunities surround- ing third-party billing in the dental industry — what worked in the past, what didn’t, and why and why not? WHY IS THIS A GOAL? Why don’t many free dental clinics bill already, preferring to rely on grants and do- nations to fund their operating expenses? The key reasons have emerged repeatedly in research, conversations, and applications for support: • Free dental clinics tend to operate with limited or volunteer staff and resourc- es and lack the personnel and infra- structure to handle the complexities