ADA calls for oral health integration in federal chronic disease care coordination efforts 

The ADA is urging lawmakers to include oral health in federal efforts to modernize care coordination for chronic disease prevention and treatment. 

ADA President Richard Rosato, D.M.D., and Interim Executive Director Elizabeth Shapiro, D.D.S., submitted a formal statement Nov. 19 to the U.S. House Committee on Ways and Means and its Subcommittee on Health, emphasizing that oral health must be considered a core component of overall health for patients with chronic conditions.  

“The ADA strongly urges that any discussion of care coordination and chronic disease explicitly include oral health. Oral health is inseparable from overall health, and preventable dental disease continues to drive avoidable pain, complications of chronic illness, cost of care, and emergency department visits, especially among low-income and medically vulnerable populations,” Drs. Rosato and Shapiro wrote.  

They offered several recommendations for congressional consideration. Among them is the need for federal definitions of “care coordination,” “care teams,” and “chronic care management” to explicitly include dentists when oral health may influence systemic outcomes. The comments also encouraged the Centers for Medicare & Medicaid Services to recognize dentists as eligible participants in care coordination activities and chronic care management services for appropriately defined populations. 

Coverage and benefit design in public programs were another area of focus. Drs. Rosato and Shapiro urged Congress to support comprehensive adult dental benefits in Medicaid and to promote clearer, more standardized information on supplemental dental benefits within Medicare Advantage plans, including covered services, annual maximums, cost sharing, and network participation. Fragmented dental benefits hinder integrated care for high-risk individuals, according to the letter.  

The Association also highlighted the importance of interoperable health data systems. Many dental practices use electronic dental record platforms that do not communicate easily with medical electronic health record systems, creating barriers to shared care planning. The ADA encouraged federal agencies to incorporate additional dental data elements into federal interoperability frameworks and to support smaller practices in adopting compatible technology and participating in health information exchanges. 

Team-based care models, especially in community health centers and rural areas, were identified as promising but insufficiently supported. To strengthen such models, the ADA recommended that CMS design and test demonstration programs and support reimbursement pathways for case managers, care coordinators, and community health workers who assist patients across dental and medical settings. 

Drs. Rosato and Shapiro also underscored the importance of federal oral health leadership at CMS, urging Congress to support maintaining a senior oral health role within the agency and to encourage CMS to promptly fill the Chief Dental Officer position in the Office of the Administrator. 

Throughout the letter, they stressed that administrative requirements should not deter dental participation in integrated care. They noted that health systems and benefit programs should promote patient access, preserve freedom of choice of a dentist, and avoid simply extending existing medical value-based or managed care frameworks onto dentistry in ways that increase administrative burden. 

“The ADA supports a health system in which oral health is fully integrated into prevention and chronic disease strategies, public programs are adequately structured and funded to recognize the oral–systemic connection, and interoperable health information technology allows dentists to collaborate effectively with medical colleagues,” Drs. Rosato and Shapiro concluded.