NCMS Morning Rounds 1-10-20

It’s Friday — enjoy the last

NCMS Morning Rounds for the week.

Jan. 10, 2020

NC Medicaid Seeks Input on Managed Care Policy Papers

Earlier this week, the NC Department of Health and Human Services (NCDHHS) issued two policy papers detailing the strategy to promote value-based care as part of the state’s move to Medicaid managed care. NCDHHS is seeking your comments on the policy papers below by Feb. 19.

If you have feedback on both papers please submit your comments to by Feb. 19.

Possible Rule Change Could Mean Improved Oral Health for NC Kids

Last month the NC Board of Dental Examiners unanimously voted to adopt a change to Occupational Licensing Boards and Commissions Rule 16W. The change would allow dental hygienists to provide preventive services such as sealants and fluoride treatments in high-need settings without a dentist’s prior exam.

Co-sponsors of the change, the North Carolina Oral Health Collaborative (NCOHC), a program of the Foundation for Heath Leadership & Innovation (FHLI), and the North Carolina Dental Society, have said making this change will increase access to preventive oral health care for North Carolina’s most vulnerable.

Before it goes into effect, the rule change must receive final approval from the Rules Review Commission, with approval anticipated in mid-January.

Tooth decay is the single most common chronic childhood disease, disproportionately affecting low-income populations. Nationwide, roughly 50 percent of children in low-income families experience tooth decay, and dental disease is responsible for a collective 51 million hours of school missed each year, notes the NCOHC in a press release about the rule change. Dental sealants, which are a thin coating painlessly applied to a child’s back teeth, dramatically reduce the likelihood an individual will develop a cavity during childhood and are one-third the cost of a cavity filling, the release states.

Currently, the state requires a prior exam from a dentist be completed before a dental hygienist can apply a sealant, adding additional cost and delays to the process.

If the rule change is approved, dental hygienists will be able to offer sealants in alternative settings like schools or after-school clinics rather than at a dentist’s office. School oral health programs, in particular, are very effective methods for reaching children who would otherwise not have access to preventive services from a private dentist, according to the NCOHC.

CDC Advisory on Respiratory Illness in China

As of January 5, Chinese authorities have reported 59 patients with ‘pneumonia of unknown etiology’ with epidemiologic links to a large wholesale fish and live animal market in Wuhan City in China. The World Health Organization (WHO) reports that seven of those patients are critically ill, and the remaining individuals are in stable condition. No deaths have been reported and no health care providers have been reported to be ill.

The US Centers for Disease Control and Prevention (CDC) is asking health departments and health care providers throughout the US to ask patients with severe respiratory disease about travel history since Dec. 1 to Wuhan City, a major transportation hub south of Beijing with a population of more than 11 million people. Currently, there are no known U.S. cases nor have cases been reported in countries other than China.

Health care professionals should notify infection control personnel and local and state health departments immediately if any patients meet these criteria. State health departments should notify CDC after identifying a case under investigation by calling CDC’s Emergency Operations Center at (770) 488-7100.

The affected patients’ symptoms began Dec. 12-29 and included fever, dyspnea and bilateral lung infiltrates on chest radiograph. The Wuhan Municipal Health Commission has not reported human-to-human transmission.

CDC has issued a level 1 travel notice (“practice usual precautions”) for this destination. WHO posted an update on this situation, including an early risk assessment.

In the News

The High Cost of Having a Baby In America, The Atlantic, 1-6-20

Learning Opportunity

The North Carolina Allergy, Asthma and Immunology Society announces its 2020 Annual Meeting and Education Symposium on Jan. 24-26 at The Blockade Runner, Wrightsville Beach, NC. Speakers include national experts on microbiomes and food allergy; immunotherapy; drug allergies and an NC legislative update. For more information and to be added to the distribution list, email


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