Arcora partnering with ACHs to integrate oral health care

As part of Washington’s Medicaid Transformation Waiver, Accountable Communities of Health (ACHs) are working to integrate and coordinate previously siloed sectors of health care to deliver a more whole-person approach to health. From the beginning, Arcora, the Foundation of Delta Dental, has sought to involve itself with ACHs to build collaborations to strengthen oral health integration.

Oral health is being increasingly recognized as an important component of overall health. Periodontal disease is linked to a variety of systemic conditions like diabetes, heart disease, stroke, or respiratory infections. In addition, dental pain or missing teeth can make eating and proper nutrition difficult and impact overall self-esteem.  And yet, oral disease is largely preventable. Currently, oral health is not often addressed in a primary care setting, a problem that affects access to care, care management, and larger population health.

The problem of oral care access is even worse for the state’s Medicaid population.  In 2016, only 22 percent of Washington adults earning less than $15,000 a year had seen a dentist in the past year, compared with 80 percent of adults earning $50,000 or more.  States are not required to provide dental coverage as a part of their Medicaid coverage and in 2011 Washington State ended its Medicaid dental coverage due to budgetary limitations caused by the recession further restricting impacting large segments of the Medicaid population’s access to care. Since then, Arcora has worked hard to build access for vulnerable populations, developing the nationally recognized Access to Baby and Child Dentistry program and investing in providing dental care in community health centers.




As a part of Medicaid Transformation, two ACHs in particular, North Sound ACH and Olympic Community of Health, have chosen oral health integration as a care focus for their transformation plans. By choosing this focus, the ACHs have committed to integrating oral health into primary care and advancing mobile or portable dental care initiatives to build access to care communities. As Medicaid transformation activities progress North Sound and Olympic will report sets of metrics related to utilization, prevention activities, and reduced use of Emergency Departments to address dental issues.

To support these transformation activities, Arcora has partnered with North Sound and Olympic to provide technical and programmatic expertise from practice coaching to sponsoring the Smile Mobile to advance mobile dental.  Supportive initiatives include:

  • Local Impact Networks (LINs) to link community oral health resources to community members who need them;
  • Provider trainings, in collaboration with Qualis Health, on integrating oral health practices, like assessment and screening for oral diseases, care coordination of referrals to dental providers, providing topical fluoride varnishes at primary care appointments, and incorporating oral health prevention education.
  • Dental Health Aide Therapists integration into tribal nations to increase access to oral health professionals in underserved communities;
  • Dentist Link, an online tool to connect patients to dental providers that accept Apple Health or private insurance;
  • Diagnostic coding training to better document oral disease, treatment, and effectuate accurate reimbursement;
  • Smile Mobile, a three chair dental office on wheels, providing dental care to children and pregnant women living in rural and underserved communities.

Though Arcora has partnered with North Sound ACH and Olympic ACH most closely due to their dental integration focus, initiatives such as LINs, Dentist Link, and Oral Health Connections are offered to all ACHs to promote deeper statewide oral health integration.