As we step into 2024, we’re taking a moment to reflect on 2023 as we begin building on what we accomplished last year.
What a year 2023 was… Among many other headlines, one of the biggest for North Carolina was the passage of Medicaid Expansion, which finally went into effect statewide on December 1st. After more than a decade of advocacy from across our state, approximately 600,000 people who were living in the health care coverage gap are newly eligible for no- or low-cost health care.
2023 was also a big year for the North Carolina Oral Health Collaborative (NCOHC) and our incredible coalition of oral health advocates. NCOHC transitioned to new leadership as Dr. Steve Cline took over as the Vice President for Oral Health at the Foundation for Health Leadership and Innovation (FHLI) and Crystal Adams was promoted to the Director of NCOHC.
As we look back at what we achieved together, we are also thinking about how we will continue to advance oral health equity in 2024 and beyond.
We are thrilled to announce that we received our largest ever grant–$1.8 million over two years—from the Blue Cross and Blue Shield of North Carolina Foundation. This will support our work influencing policy, developing and promoting workforce strategies, elevating partnerships, and engaging with communities across North Carolina.
Moreover, it will enable us and our partners to advance the recommendations from the North Carolina Institute of Medicine (NCIOM) Oral Health Transformation Task Force Report.
We are also delighted to announce that The Duke Endowment—a longtime partner and supporter of our collaborative work—has continued to invest in oral health equity by awarding NCOHC a $1.2 million grant over the next three years. We are also grateful for the ongoing support of the Dogwood Health Trust and the CareQuest Institute.
With this funding secured, we will expand our programs and support a more accessible, equitable oral health ecosystem, especially for rural and other underserved communities across our state.
Read about our collective successes with our statewide partners and get a sneak peek of what’s to come in 2024.
At the North Carolina Museum of History on April 26, 2023, the North Carolina Rural Health Association (NCRHA) and NCOHC, along with our partners and numerous legislators, met to discuss ways to address the growing health care needs of all North Carolinians.
We presented awards to impactful state leaders, including Representative Donna McDowell White (NC House District 26), Senator Jim Burgin (NC Senate District 12), Senator Jim Perry (NC Senate District 2), Dr. Amanda Stroud (Dental Director, AppHealthCare), and Michelle Fortune (CEO, St. Luke’s Hospital).
Additionally, NCOHC announced its legislative priorities for the 2023-2024 legislative session, which include:
- Enacting a state budget to allow House Bill 76 (Medicaid Expansion) to take effect — we did it!
- Creating a Rural Areas Forgivable Loan Pilot Program to encourage dentists, hygienists, and assistants trained in North Carolina to stay and bring more providers to rural communities by adding funding for dental staff loan forgiveness.
- Promoting legislation to allow all dental staff to practice at the full scope of their training and licensure (e.g., removing regulatory burdens for hygienists and assistants).
Along with that, the North Carolina Rural Health Association, another FHLI program, announced its 2023 legislative priorities, which included 1) Medicaid Expansion and access to care, 2) health workforce pipeline, 3) maternal and child health, and 4) broadband for all.
On June 21, 2023, we hosted Oral Health Day 2023. The theme for this year’s event was, “Challenges and Opportunities for the Dental Team.” Kathy Colville provided a keynote speech and panelists brought expertise and ideas for how North Carolina can become a healthier, more equitable state.
“We have truly amazing and exceptional people holding up an inadequate system,” said Colville, President and CEO of the North Carolina Institute of Medicine (NCIOM). She also spoke about the necessity of a systems-level approach to improving oral health and how integral oral health is to many meaningful aspects of our lives:
“The mouth communicates, eats, smiles, frowns, and makes silly faces. Our mouth and teeth allow us to show emotion, communicate our thoughts, and be human. With proper oral health, our mouth can do all of these things better.”
Other key topics discussed throughout the day included 1) Medicaid Expansion and dental reimbursement rates, 2) building community trust, and 3) advocating for and investing in an adequate, accessible, and equitable oral health care delivery model throughout North Carolina.
We hope you will join us for Oral Health Day 2024, which will be announced soon!
In October we joined forces with the Blue Cross and Blue Shield of North Carolina Foundation and the CareQuest Institute for Oral Health to host a final COrHT Initiative convening. The two-year initiative launched in 2022 to help safety-net practices pilot a value-based care payment model, following CareQuest’s “three-domain framework” that includes:
- Tele-prevention (teledentistry)
- Minimally invasive care (non-surgical treatment of disease)
- Integration of oral health with overall health care
The initiative was so successful that we are excited to announce it will continue to live on! 2023 was originally intended to be the final year of the initiative, but at the 2023 convening every participating site agreed to stay involved and keep the initiative going.
We look forward to continuing to collect data, coach providers, and help explore avenues to transition to a value-based oral health system.
Western North Carolina (WNC) Oral Health Convening
We facilitated a WNC Oral Health Convening at the Lake Junaluska Conference Center in Waynesville this year with support from the Dogwood Health Trust. Dedicated oral health leaders working directly in small towns and rural communities throughout the Appalachian region came together for an engaging discussion about access to care, the current dental workforce, and policy priorities.
Following the sale of Mission Hospital to HCA Healthcare, NCOHC stepped in to help continue the convening of a WNC Steering Committee that formerly worked through the Mission Hospital Children’s Dental Clinic.
The goals of the committee and ongoing convenings are to 1) increase health care integration by facilitating collaboration among dental, medical, and public health providers, 2) expand access to oral health care for rural and other underserved communities, and 3) enhance oral health literacy for families, policymakers, and providers, and more.
NCOHC partnered with the Mountain Area Health Education Center (MAHEC) to launch a mini-residency program at their WNC facilities. The goal was to better equip oral health safety-net providers in the region with the skills to meet people’s comprehensive oral health care needs, rather than referring them to an outside specialist.
The first cohort of four safety-net dentists received hands-on complex surgeries training. There is a severe shortage of specialty and surgical oral health care available to uninsured North Carolinians or those with Medicaid insurance. By “training up” already qualified providers in safety-net settings, people who would otherwise be left without options will be able to access the care they need and deserve.
Patient Advocate Pilot Program
This year marked year two of the Patient Advocate Pilot Program. Four dental practices in the WNC region hired patient advocates, employees who help people navigate the system and access the entire spectrum of health services, including oral health care.
NCOHC provided training and ongoing support, and we are continuing to collect data from the patient advocate pilot. Ultimately, we will use this information to analyze the effectiveness of the program, which will wrap up in 2024.
Participating sites include Mountain Community Health Partnership, Blue Ridge Health, MAHEC Dental Health Center and Center for Advanced Training, and the ECU Community Service Learning Center in Sylva, North Carolina.
2024 Preview: What to Expect
NCIOM Oral Health Transformation Task Force Recommendations
In January 2022, NCIOM and NCOHC launched the Oral Health Transformation Initiative, a multi-sector task force to evaluate, assess, and make oral health system transformation recommendations. More than 70 key oral and health care stakeholders, policymakers, academics, and other influencers have contributed through collaborative design to identify critical oral health opportunities in North Carolina.
The task force will release an Oral Health Transformation Task Force Recommendations Report by February 2024. The report will cover issues ranging from payment and benefit design to care integration, pathway development, and consumer experience. It will also lay out a path forward to implement key policy priorities to improve access and equity in oral health care across North Carolina.
Portrait of Oral Health Report
As we have done in the past, NCOHC engaged with UNC-Chapel Hill MPH capstone students throughout the year, enabling them to gain hands-on experience synthesizing data and interviewing key stakeholders to develop an informative report about the status of oral health in North Carolina.
This year, a group of four students are still dedicating their time, energy, and talent to put together the Portrait of Oral Health 2024. This report will be an updated version of the original Portrait of Oral Health [PDF] published in 2017 by a group of oral health professionals, government officials, and community-based organizations.
Join Us on the Road to More Equitable Oral Health Across NC
With 2023 swiftly falling into our rearview mirrors, we feel deeply grateful for the dedicated partnerships and collaborative efforts we have had the privilege to be part of. As we enter a new year, we feel excited about embarking on the open road ahead together.
Our team will continue to advocate for and advance policies and initiatives that create a healthier, more equitable oral health landscape for every North Carolinian. Stay tuned for details about events like this year’s Legislative Breakfast and Oral Health Day.
NCOHC, a Foundation for Health Leadership & Innovation program, works to advance systems-level changes, improving the overall health and well-being of all North Carolinians by increasing access and equity in care. Sign up for our monthly newsletter to join the network and get involved!