Medicaid Dental Directed Payments
A little about the program
The Oregon Health Authority (OHA) has created the Dental Directed Payment Incentives program for Coordinated Care Organizations (CCOs) like PacificSource Community Solutions to incentivize providers in their network.
The incentives are meant to increase preventive dental care, maintain and expand the dental workforce, and support community efforts to engage local dental providers and help members access dental care.
Eligibility
To qualify for directed payments, providers must be contracted with a Coordinated Care Organization (CCO) to serve its members and provide dental services to CCO members during calendar the current calendar year.
Incentives
There are three Dental Directed Payment options for CCO-contracted dental providers.
CCOs will receive payments to distribute the incentives in the next calendar year.
New Dental Provider Annual Incentive
New dental providers who sign up and provide service in the current calendar year are eligible to receive an annual bonus. The bonus varies by services provided.
Provider Retention and Increased Access Incentive
Existing dental providers who retain service levels from previous calendar year are eligible for an annual bonus. The bonus can also increase if services provided in current calendar year increase from previous calendar year levels.
Bundled Payments for Pediatric and Minimally Invasive Services
(once per year, per member)
Dental providers who complete a pediatric preventative bundle will receive an add-on payment of $30 per bundle.
Dental providers who complete a minimally invasive bundle will receive an add-on payment of $50 per bundle.
More details from OHA
For more detailed program information, visit the OHA Dental Directed Payment Incentives web page.
OHA has provided guidance and and FAQ in a single document. Download the Dental Directed Payment Guidance and FAQ (PDF).
For additional education, you can view a video recording of the OHA CCO Dental Directed Payment Webinar, and the slide deck from that webinar (PDF).
Partner with us
Not yet a contracted Medicaid dental provider with PacificSource? We contract with dental care organizations (DCOs) to administer the dental benefit, contract with dental care providers, and reimburse for dental services. Contract with any of the three DCOs listed below to serve our members and be a participating Medicaid provider in our regions.