ADHA responds to ADA MLP reports

The American Dental Hygienists' Association (ADHA) is questioning the methodology used in the ADA's midlevel provider (MLP) economic viability reports, contending that the reports excluded key information and do not accurately reflect the MLP models being proposed in some states.

After reviewing the six studies released by the ADA on July 25, the ADHA found that "the methodology utilized to conduct the study impacts the validity of the conclusions drawn by the research," according to an ADHA press release.

The research, conducted by ECG Management Consultants, views the access-to-care crisis "through the lens of economic viability and makes assumptions about midlevel providers that may not be accurate," the ADHA stated.

ADHA advocates for evidence-based strategies that support improved oral health and wellness. The organization's main concerns with the ADA reports are the following:

• They excluded information about -- and from -- midlevels that are currently in practice in favor of projected data about proposed workforce models.
• The provider models they included do not accurately describe those proposed in the five states addressed in the study.

The reports considered the financial sustainability of three alternative provider models: the dental health aide therapist (DHAT), the dental therapist (DT), and the advanced dental hygiene practitioner (ADHP). Research was not conducted in Minnesota and Alaska, the only two states where midlevel dental providers are actually currently practicing.

Midlevel providers have been proposed in Connecticut, Washington, Vermont, New Hampshire, and Kansas -- the states covered by the ADA reports -- but the reports do not accurately reflect the models being proposed, according to the ADHA. Kansas and Vermont are each considering a licensed dental hygienist with one additional year of education. In addition, Washington has considered legislation to establish two providers: a two-year educated dental practitioner and a dental hygiene practitioner who is a licensed dental hygienist who has completed a postbaccalaureate advanced dental hygiene therapy education program.

"The access-to-care crisis is bigger than a funding problem and will require the entire dental team working to the extent of their education and skills," the association stated. "ADHA encourages ADA and all stakeholders to engage collaboratively across disciplines to define solutions."