Consensus Statements on Oral Health, Medicare, and Oral-Systemic Care
The Santa Fe Group develops and supports consensus statements, position papers, and calls to action that advance oral health equity, strengthen the integration of oral health and overall health, and influence Medicare and health policy. By convening experts across dentistry, medicine, nursing, public health, and industry, we highlight the evidence linking oral disease to chronic conditions such as diabetes, cardiovascular disease, dementia, and cancer, and advocate for access to medically necessary oral health care for all.
Community Statement on Medicare Coverage for Medically Necessary Oral and Dental Health Therapies
The undersigned organizations are proud to join in support of Medicare coverage for medically necessary oral/dental health therapies.
It is well established that chronic diseases disproportionately impact Medicare beneficiaries and impose a substantial cost on the federal government. It is also well established that untreated oral microbial infections are closely linked to a wide range of costly chronic conditions, including diabetes, heart disease, dementia, and stroke. In addition, oral diseases have been documented by researchers and medical specialty societies as precluding, delaying, and even jeopardizing medical treatments such as organ and stem cell transplantation, heart valve repair or replacement, cancer chemotherapies, placement of orthopedic prostheses, and management of autoimmune diseases.
Despite these factors, most Medicare beneficiaries do not currently receive oral/dental care even when medically necessary for the treatment of Medicare-covered diseases. In fact, Medicare coverage extends to the treatment of all microbial infections except for those relating to the teeth and periodontium. There is simply no medical justification for this exclusion, especially in light of the broad agreement among medical specialists that such care is integral to the medical management of numerous diseases and medical conditions. Moreover, the lack of medically necessary oral/dental care heightens the risk of costly medical complications, increasing the financial burden on Medicare, beneficiaries, and taxpayers.
Some Medicare Advantage (MA) plans are providing coverage of medically necessary periodontal treatment to targeted enrollees with diabetes, heart disease or stroke. This is an important step forward, and medically necessary oral/dental healthcare including periodontal treatment should be provided in traditional Medicare as well. According to some reports, such plans have realized important benefits from oral/dental health coverage, including markedly lower hospitalization and emergency department admission rates as well as substantial cost reductions.
The Medicare program and all its beneficiaries should not be without the vital clinical and fiscal benefits of coverage for medically necessary oral/dental health therapies. Given the significant potential to improve health outcomes and reduce program costs, we urge Congress and the Administration to explore options, including utilization of existing authority, for extending such evidence-based coverage for all Medicare beneficiaries.
Consensus Partners
- AARP
- Acuity Specialists
- Adenoid Cystic Carcinoma Research Foundation
- AIDS Foundation of Chicago
- Allies for Independence
- American Academy of Maxillofacial Prosthetics
- American Academy of Nursing
- American Academy of Periodontology
- American Association for Dental Research
- American Association of Clinical Endocrinologists
- American Association of Colleges of Nursing
- American Association of Diabetes Educators
- American Association of Hip and Knee Surgeons
- American Association of Kidney Patients
- American Association of Oral and Maxillofacial Surgeons
- American Association of Nurse Practitioners
- American Autoimmune Related Diseases
- American College of Cardiology
- American College of Emergency Physicians
- American College of Gastroenterology
- American College of Physicians
- American College of Prosthodontists
- American College of Rheumatology
- American Dental Assistants Association
- American Dental Education Association
- American Dental Hygienists' Association
- American Diabetes Association
- American Head and Neck Society
- American Kidney Fund
- American Liver Foundation
- American Medical Association
- American Nephrology Nurses' Association
- American Network of Oral Health Coalitions
- American Nurses Association
- American Parkinson Disease Association
- American Psychiatric Association
- American Public Health Association
- American Society for Radiation Oncology
- American Society of Clinical Oncology
- American Society of Nephrology
- American Society of Transplant Surgeons
- American Society of Transplantation
- American Thoracic Society
- Arthritis Foundation
- Association of Community Cancer Centers
- Association of Dental Support Organizations
- Association of State and Territorial Dental Directors
- Autistic Self Advocacy Network
- Brain Injury Association of America
- California Dental Association
- California Medical Association
- Catholic Health Association of the United States
- Center for Health Law and Policy Innovation
- Center for Medicare Advocacy
- Children’s Dental Health Project
- Cornerstone Dental Specialties
- Crohn's and Colitis Foundation of America
- Dental Lifeline Network
- Dental Trade Alliance
- DentaQuest Partnership for Oral Health Advancement
- Disability Rights Education and Defense Fund
- Eating Disorders Coalition
- Epilepsy Foundation
- Families USA
- Georgia AIDS Coalition
- Gerontological Advanced Practice Nurses Association
- Head and Neck Cancer Alliance
- Henry Schein Cares Foundation
- HIV Medicine Association
- Hispanic Dental Association
- International Pemphigus and Pemphigoid Foundation
- John A. Hartford Foundation
- Justice in Aging
- Leukemia and Lymphoma Society
- Lupus and Allied Diseases Association, Inc.
- Lupus Foundation of America
- Medicare Rights Center
- Mended Hearts
- Mental Health America
- Minnesota Dental Therapy Association
- National Alliance of State & Territorial AIDS Directors
- National Alliance on Mental Illness
- National Association of Area Agencies on Aging
- National Association of Community Health Centers
- National Association of Dental Plans
- National Association of Nutrition and Aging Services Programs
- National Association of Social Workers
- National Association of States United for Aging and Disabilities
- National Comprehensive Cancer Network
- National Committee to Preserve Social Security and Medicare
- National Consumer Voice for Quality Long-Term Care
- National Council for Behavioral Health
- National Dental Association
- National Forum for Heart Disease and Stroke Prevention
- National Health Law Program
- National Interprofessional Initiative on Oral Health
- National Kidney Foundation
- National League for Nursing
- National Medical Association
- National Multiple Sclerosis Society
- National Network for Oral Health Access
- National Osteoporosis Foundation
- National Rural Health Association
- National Stroke Association
- Oncology Nursing Society
- Oral Cancer Foundation
- Oral Health America
- Oral Health Nursing Education and Practice Program
- Pacific Dental Services Foundation
- Parkinson's Foundation
- Patient-Centered Primary Care Collaborative
- PEW Dental Campaign
- Preventive Cardiovascular Nurses Association
- ProHEALTH Dental
- Renal Physicians Association
- Santa Fe Group
- School-Based Health Alliance
- Scleroderma Foundation
- Senior Charity Care Foundation
- Sepsis Alliance for Medically Necessary Oral and Dental Health Therapies
- Sjogren's Syndrome Foundation
- Society for Transplant Social Workers
- Support for Persons with Oral, Head, and Neck Cancer
- The AIDS Institute
- The Arc of the United States
- The Gerontological Society of America
- The Michael J. Fox Foundation
- The National Forum of ESRD Networks
- The Society for Thoracic Surgeons
- The TMJ Association
- WomenHeart, The National Coalition for Women with Heart Disease
Position Statement on Oral-Systemic Health
After decades of research and thousands of scientific papers, the relationships between oral health, especially periodontal health, and systemic health are well known. Moreover, during the past ten years, data analysis by health economists, and public statements and actions by several large, private dental insurers have identified additional benefits of oral health by revealing that insured individuals who receive treatment for periodontal disease show fewer hospitalizations and reduced cost of care for a number of systemic diseases including diabetes, cardiovascular disease, and stroke.
Evidence and Implications
The Santa Fe Group has concluded that sufficient evidence now exists that periodontal disease is a contributory cause to certain systemic diseases, and the public should benefit from this knowledge. Therefore, Medicare, Medicaid, and other public and private health insurance programs should incorporate oral health benefits as a component of comprehensive health insurance.
Why Oral Health Coverage Matters
These health benefits will not only improve oral health for its own sake — including speech, mastication, and social acceptance — but will also produce substantial economic benefits and total health improvement for the public.
COVID-19 - A Call to Action to the Dental Profession
In our 25-year history as an action-oriented, nonprofit think tank, passionate about improving lives through oral health, the volunteer members of the Santa Fe Group have never experienced anything like the COVID-19 pandemic. We share in the nation’s collective shock and grief as every hour brings news about rising health care systems demands, critical stay-at-home orders, new cases, and deaths. We also marvel at the extensive work of our dental colleagues who fight under unprecedented conditions for ways to address emergency oral health services.
Therefore, as part of our well-established mission to connect, convene, and communicate with healthcare professionals to help catalyze change, we ask you to consider two important endeavors:
Addressing Response and Recovery
Currently, the Santa Fe Group is working with our partners to develop a thoughtful plan, including appropriate testing protocols and in-office mitigation techniques, to win patient confidence and help bring back the practice of dentistry. Also, the Santa Fe Group will work with other organizations to develop a comprehensive consensus statement and white paper on the role of dentistry in the COVID-19 response that takes into account all phases, including preparing for the second wave and facilitating with future testing and vaccine administration. If you are interested in keeping abreast of these efforts, please send your email/contact information to: SantaFeGroupOralHealth@gmail.com.
Answering the Call to Volunteer
Although the entire dental enterprise and dental professionals are experiencing tremendous volatility, we must not overlook dental team members’ much-needed skills to support both the public health and clinical care needs while we collectively work to return to practice. Given the urgency of the moment to save lives and contribute to this stage of the response, we call upon the dental profession and the entire dental enterprise to consider joining us in an effort to contribute to the COVID-19 crisis through volunteering.
Needed services are diverse, vary geographically, and include support for contact tracing, hotline management, health education, triage and screening services, provision of consultations for oral problems, and much more. Should you wish to join in this effort, please see below for helpful links and resources.
Links to Resources to Volunteer Your Services
- Medical Reserve Corps – Access your local unit
- Hospital Associations Directory
- Emergency System for Advanced Registration of Volunteer Health Professionals (ESAR-VHP)
The effects of the COVID-19 pandemic will be long lasting and its imprint on all health professions will be profound. However, right now the passing minutes are too precious to waste. We call on you to use your time and your critical skills to help make a difference.
With gratitude and support,
The Volunteer Members of the Santa Fe Group
SantaFeGroup.org
