Turning on a Dime

Turning on a Dime

Edward J. Vigna, D.D.S.*:

As we approach the “dog days of summer” (defined as “a period of stagnation or inactivity”), nothing is slow or inactive with the ADA. Our new Executive Director, Dr. Kathy O’Loughlin, hit the ground running June 1 and has not stopped. I continue to be impressed with her ability and the manner in which she approaches her new role.
The June Board of Trustees meeting was highlighted with work on the budget. In light of current economic conditions, the Board has carefully evaluated the 2010 ADA budget. All areas of the ADA were asked to make significant expense reductions in this year’s budget, and the proposed reductions were spread broadly. The good news is that the budget the Board of Trustees will submit for House of Delegates approval at the Annual Session will be balanced and includes no dues increase. Due to anticipated heightened interest in the budget, we will release a draft of Board Report 2, along with budget assumptions, electronically and earlier than in years past. I look forward to any and all comments once the budget is released. The Finance Committee and the BOT worked long and hard to present a budget with significant reductions, yet which is very workable and continues to provide members with expected services.

Strategic Planning Committee
The chair of the Strategic Planning Committee of the Board of Trustees made a presentation which outlined strategic planning background information and ADA’s prior and current strategic planning process. The BOT discussed the process, and considered the importance of using the Strategic Plan to better focus Association resources, deal with emerging issues, align with the budget cycle, and communicate to the membership at large. We will continue to make significant changes to how Strategic Planning will be conducted within the Association.

Annual Session Fees to Increase
The member registration fees for the ADA Annual Session have not been increased since 1996, even though the inflation rate from 1996 to 2009 was approximately 37%. The Board agreed to increase registration fees for the 2011 ADA Annual Session in Las Vegas from $50 to $75 for ADA member dentists. Fee increases for other categories of registrants will be increased by either $10 or $25.

Update on ADA CE Online
The Board received an update of the status of the ADA CE Online program, and has requested that the Council on Dental Education and Licensure assume responsibility for oversight of ADA CE Online consistent with ADA Bylaws, and that CDEL continue to engage volunteers and consultants from other ADA agencies as appropriate in carrying out this responsibility. CDEL will report to the Board in April 2010 regarding the status of ADA CE Online.

BOT Urges States to Accept Board Examination Results
Given the recent decision by the Central Regional Dental Testing Service (CRDTS) to terminate its relationship with the American Board of Dental Examiners (ADEX) effective June 30, 2009, the BOT urged that all state dental boards that accept the ADLEX dental examination results continue to accept results of the ADEX/NERB/CRDTS/Nevada examinations taken prior to June 30, 2009 for their established standard acceptance period.

Dental Quality Alliance Steering Committee
At the 2008 ADA Annual Session, the House adopted Resolution 34H-2008, approving the exploration of the development of a Dental Quality Alliance (DQA) in the oral health care delivery system and asking the Board, in consultation with the appropriate ADA agencies, to determine if participation should be pursued. Following consultation with the Councils on Dental Benefit Programs, Dental Practice, and Government Affairs, the Board agreed to the composition of a steering committee of the DQA. It will be comprised of nine members, to include one representative nominated by the Council on Government Affairs, Council on Dental Practice, and Council on Dental Benefit Programs, and one representative appointed by each of the following agencies: the ADA Board of Trustees, the American Academy of Pediatric Dentistry, the Academy of General Dentistry, the National Association of Dental Plans, the American Dental Education Association, and the Centers for Medicaid and Medicare Services. The ADA members of the DQA shall be appointed by the president. The Board of Trustees member will serve as the initial chair. The Board also set the length of membership, pattern of replacing members, and general approach for the education of the profession about the purpose and activities of the DQA.

ADA Business Enterprises Inc.
In recent months, ADA Intelligent Dental Marketing (ADAidm) has encountered significant production and operational difficulties. Unfortunately, some of our members have experienced this directly. On behalf of the ADA leadership, I want to express our regret that this occurred. After careful consideration, ADA Business Enterprises Inc. (ADABEI) has determined that the best solution for ADA members and our association is for ADAidm to resolve outstanding contractual obligations and for ADABEI’s business relationship with ADAidm to be dissolved. If any of you are clients of ADAidm and need any resolution to any issues of unfulfilled obligations, please contact me at vignae@ada.org.

Third-Party Payers
Our relationship with third-party payers continues to attract our attention. On the positive side, Rhode Island was successful in passing a bill prohibiting a third party from limiting payment for non-covered services. This is the first action I have heard that has been successful regarding this practice. I encourage more states to pursue this type of legislative action. On the down side, we just learned that United Concordia has instituted a policy similar to Delta, establishing limits for non-covered expenses. There is growing concern by members about these recent efforts in the benefits industry. I want to let you know that the Washington office has already been in discussion with a key lawmaker about introducing legislation to deal with this and similar benefit issues. We are talking with the representative about both stand-alone legislation and the possibility of attaching some provisions to a must-pass bill, such as health care reform. While we will, of course, make a very aggressive grassroots push for the former approach, the latter may be more effective by employing stealth.

Health Care Reform
Last be not least, the 800-pound gorilla. Mixed messages are the order of the day in Washington of late, as health care reform continues to occupy center stage. At the same time that some congressional leaders seem to be coalescing around the idea of a public plan as a counterpoint to private insurers, White House Chief of Staff Rahm Emanuel has signaled that the Administration could accept something else, if it met the same objective of infusing more competition into the insurance market. That something else could be health cooperatives, an idea being touted by Senator Kent Conrad (D-SD), among others.

While we have seen draft bills from the Senate HELP Committee and the House, we are still awaiting the Senate Finance Committee’s effort. The primary reason that one is still under wraps is that the committee chair, Max Baucus (D-MT), has been trying to bridge the partisan divide and attract Republican support. That may become more difficult, as Majority Leader Harry Reid has reportedly lost patience with that approach, claiming that any changes made to attract a handful of Republican votes could result in twice that many defections from liberal Democrats. One imagines that the seating of Al Franken as the junior senator from Minnesota, which gives the Democrats their 60th vote in the Senate, may encourage Reid to pursue a more partisan approach.

While Democrats now have the votes to bypass Republican efforts to stop legislation, that assumes a solidarity on major issues that may not exist. When it comes to health care reform, for example, there are a number of moderate-to-conservative Democrats in the upper chamber who have serious reservations about some key elements (the public plan, the tax provisions, mandates). A 60-vote strategy also assumes able bodies, and both Senators Robert Byrd and Ted Kennedy have been sidelined for months with serious medical issues.
I hope you all continue to enjoy our summer. Please contact me at vignae@ada.org or (402) 770-7070. n

*Dr. Ed Vigna is the Trustee to the Tenth District of the American Dental Association, representing Iowa, Minnesota, Nebraska, North Dakota, and South Dakota.