Reimbursing Medical Providers for Preventive Oral Health Services: State Policy Options
Tooth decay, while highly preventable, is the most common chronic disease among children, and it disproportionately affects children from families with low incomes. Many state Medicaid agencies are working to increase children’s access to preventive oral health services by reimbursing primary care medical providers for fluoride varnish application, an oral examination or screening, and/or caregiver education about establishing good oral health habits. This report is intended to help states considering adopting similar policies; it draws from the experiences of Iowa, Minnesota, North Carolina, Utah and Washington to describe some of the major elements of policy design and implementation, as well as lessons learned associated with medical provider reimbursement.
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For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 
