Provider updates

Have you noticed more attention for patients with diabetes this year? The Oregon Health Authority’s (OHA) Oral Evaluation for Adults with Diabetes metric emphasizes the importance of oral health, and focuses on the completion of a dental exam to help improve diabetes health outcomes. The objective is to spread the word: routine diabetes care includes regular dental care!

In order to be successful, this metric requires a concerted effort and out-of-the-box thinking by both primary care and dental teams. Primary care providers are being asked to include oral health messaging as part of routine diabetes care management and to navigate these patients to dental clinics. Primary dental providers are being asked to provide a dental exam (D0120, D0150, or D0180) for these patients. It takes the entire dental team to make this happen. Schedulers, navigators, assistants, hygienists, and managers are invaluable resources for ensuring the exam is completed.

The metric denominator includes patients age 18 years or older with diabetes and is identified by physical health and pharmacy claims. The metric numerator, however, can only be provided by a dentist. These patients, including those who are edentulous, must complete a dental exam during the metric’s calendar year, in order to be counted in this metric. The three dental exam codes that contribute toward this metric are:

• D0120 (Periodic Oral Evaluation)
• D0150 (Comprehensive Oral Evaluation)
• D0180 (Comprehensive Periodontal Examination)
• Requires full periodontal charting

D0140 (Limited Oral Evaluation) and D0191 (Oral Assessment) do not count toward this metric.

Partners in our network have shared processes being implemented to support the completion of a dental exam for these patients with diabetes:

• Text message outreach
• Saturday clinics
• Targeted outreach and tracking system
• Data visualization boards
• Scheduling notes in the EHR to alert providers

CareOregon is also developing primary care provider and patient materials, including brochures and trainings for diabetes care teams. Areas of focus of these materials include the bidirectional relationship between diabetes and periodontal disease, key messages on dental care as part of routine diabetes care, and implementation of pathways to connect patients to dental care.

Questions about these materials may be directed to CareOregon’s Oral Health Integration Team at  oralhealth@careoregon.org.