Dr. Bragg Bids Farewell to Dental Program He Helped Build

OHCA Chief Dental Officer Leon Bragg, D.D.S., will retire on July 13, 2017.

Sometime in early 2003, the state of Oklahoma determined the experiment in dental managed care wasn’t an appropriate solution for the SoonerCare (Oklahoma Medicaid) program. State leaders made the decision to bring the program in-house at the Oklahoma Health Care Authority, which would self-administer the SoonerCare dental program.

OHCA chose me to tackle the job. I brought with me 21 years of experience as a Medicaid dentist and five years as a full-time faculty member at the University of Oklahoma (OU) College of Dentistry, of which I was assistant Dean of Clinics upon my departure.

At the end of 2003, there were 359 dentists with SoonerCare contracts, and the program had invested approximately $50,000 toward oral health maintenance for Oklahomans. Dental Manager Ella Matthews, R.N., was the only full-time person attending to these matters.

At the time I began work at the OHCA on Feb. 23, 2004, the major issue was Medicaid’s structural weaknesses. These faults stemmed from policies that made the program inadequate to meet oral health needs. Mike Fogarty, then CEO of OHCA, said to me, “We have problems with dental. Less than 100 dentists are accepting our recipients, and the oral surgeons are boycotting the program. Fix it!” And so, my journey began.

It was time to end all activities of the managed care programs in the state and implement sustainable dental public health care to meet the needs of our members. Mrs. Matthews was fully supportive of my efforts. Her experience and knowledge of the agency was fundamental to the success of the changes.

It is difficult for some to understand the importance and impact of SoonerCare because the program is so large and serves so many different population groups.

This was a window of opportunity for me due to the managed care crisis, as policies under that system did not serve us in the economic and social times. While others discussed ideas, I sought realistic solutions at reasonable costs. To be successful would take broad support and action. Medicaid makes a positive difference in the lives of hundreds of thousands of low-income Oklahomans, and the OHCA allowed me to create a quality dental program.

OHCA increased the reimbursement rate paid to dentists in January 2004. This was helpful and needed. The annual report for SFY 2004 indicated that SoonerCare covered roughly 463,000 low-income children and just more than 60,000 low-income adults in families with children. This made SoonerCare a major economic factor in the dental community. By the end of 2004, Dental Services had grown to include 454 contractors.

Our contracted partners had grown to 804 by 2008. I had 519,880 children (members under age 21) in our program, and the OHCA invested $125 million into the Oklahoma dental community and the state.

Administering a Medicaid program is challenging. One must consider the varied member groups; the scope of the benefits packages; interactions with other payers; regulatory and political transactions; joint federal and state financing and most certainly the effect of all of this on my dental colleagues.

While it’s time for me to retire and move on to the next phase in my life, the work must continue to educate on the value of oral health. Partner dentists must continue to care for the needy while understanding that agency staff will do everything possible to ensure that appropriate services are provided to SoonerCare members. Focus must continue to be on increasing the reimbursement for dentists and improving the quality of services rendered.

Learn more about the SoonerCare Dental program here.