2017
- Center for Oral Health Systems Integration and Improvement established and continued under the project name Consortium for Oral Health Systems Integration and Improvement
Background
The Center for Oral Health Systems Integration and Improvement (COHSII) worked with national, state, and local key stakeholders to improve systems of care in support of a quality improvement, patient-centered approach that addresses the comprehensive oral health needs of the maternal and child health (MCH) population (pregnant women, infants, children, and adolescents, including those with special health care needs, and their families). COHSII began with funding for a 4-year (2017–2021) cooperative agreement from the Maternal and Child Health Bureau (MCHB), Health Resources and Services Administration (HRSA) and continued under the revised project name, Consortium for Oral Health Systems Integration and Improvement (also abbreviated as COHSII), with funding for a 3-year (2021–2024) cooperative agreement from MCHB, HRSA.
COHSII (2017–2024) was led by the National Maternal and Child Oral Health Resource Center working in collaboration with the Association of State and Territorial Dental Directors and the Dental Quality Alliance. COHSII served as a central convener, coordinator, and promoter of new oral health knowledge and skills.
COHSII (2017–2021) had a three-pronged approach, which included:
- Providing Title V recipients with technical assistance (TA) and training and learning collaboratives with peer-to-peer learning opportunities to foster knowledge and skills to improve access to and quality of oral health care for the maternal and child health (MCH) population.
- Identifying and developing MCH oral health quality indicators to monitor services delivered in public health programs and systems of care to improve access to and quality of oral health care for the MCH population.
- Creating learning and engagement opportunities focusing on oral health for professionals working in or with Title V agencies through the development and dissemination of resources.
COHSII (2021–2024) had a two-pronged approach, which included:
- Providing high-quality and timely targeted TA to two learning collaboratives to advance the integration of preventive oral health care into primary care for the MCH population.
- Providing high-quality and timely universal TA to professionals serving the MCH population in all states and territories to increase knowledge and enhance skills useful for advancing the integration of preventive oral health care into primary care.
Impact
Both federal funding awards allowed COHSII to play a pivotal role in strengthening the integration of preventive oral health care into primary care across the United States.
MCHB tasked COHSII with convening a quality-indicator advisory team to guide and inform the identification and use of existing quality indicators to monitor care delivered in public health programs and systems of care to improve access to and quality of oral health care for the MCH population. Oral Health Quality Indicators for the Maternal and Child Health Population constitutes a standardized and aligned quality-measurement system designed to promote state efforts to monitor and improve quality of care. Incorporating indicators into state-oral-health-quality-measurement and state-oral-health-surveillance plans for reporting over time will help states assess system performance, identify priority areas, develop action plans to drive improvements in care quality and outcomes, and assess progress in achieving improvement goals. Five states—Georgia, Illinois, Iowa, Michigan, and Rhode Island—were selected to pilot the process of reporting on the quality indicators. States learned how to employ the indicators to enable assessments of system performance and identify areas that can be targeted for improvement.
COHSII provided TA to oral health projects funded by the Maternal and Child Health Bureau, including the Perinatal and Infant Oral Health Quality Improvement (PIOHQI) in 2018 and 2019 and the Networks for Oral Health Integration (NOHI) Within the Maternal and Child Safety Net (2019–2024). The NOHI projects conducted environmental scans that informed policy and practice by identifying factors such as Medicaid scope-of-practice and payment structures that influence integration. As a result, states gained improved capacity to track key oral-health-quality indicators, adopt standardized protocols, and apply continuous quality improvement to embed oral health into MCH settings.
COHSII also provided TA to the Integrating Oral Health Care and Primary Learning Collaborative: A State and Local Partnership (2022–2024), which had a state and local component in nine states. The state component focused on assessing and improving systems-level capacity for integrating oral health care and primary care for pregnant women. The local component focused on integrating oral health care and primary care for pregnant women in community health centers. The projects fostered interprofessional collaboration among health center teams, including medical assistants and midwives, to implement oral health core competencies and improve care coordination.
Collectively, COHSII has driven sustainable, system-level transformation—advancing access, quality, and equity in preventive oral health care for women and children nationwide.
Sources
Battani K, Kolo S, Owen C, Fischer D, Bagin A. 2024. Integrating Oral Health Care and Primary Care Learning Collaborative: A State and Local Partnership Final Report. Washington, DC: National Maternal and Child Oral Health Resource Center.
National Maternal and Child Oral Health Resource Center. 2024. Consortium for Oral Health Systems Integration and Improvement [webpage].
National Maternal and Child Oral Health Resource Center. 2020. Oral Health Quality Indicators for the Maternal and Child Health (MCH) Population [webpage].
Phipps KR. 2023. Networks for Oral Health Integration (NOHI) Within the Maternal and Child Health Safety Net: Environmental Scan 2023 Chartbook. Washington, DC: National Maternal and Child Oral Health Resource Center.
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