The VETSmile Pilot Program, which began July 1, 2021, is a newly launched program that has as its aim to connect Veterans who do not have VA Dental benefits with community dental providers who offer reduced-fee dental care and/or pro bono care.  The dental care is not funded by VA. The program administrator is the Center for Care and Payment Innovation also known as CCPI.  

VHA CCPI is authorized by MISSION Act Section 152 to accelerate VA’s transition to high-value care, with their mission to create efficiencies, promote equity and achieve the best health outcomes for all Veterans. 

In the VETSmile program, CCPI is targeting Federally Qualified Healthcare Centers (FQHC’s) and Dental Schools who have the ability to provide reduced-fee and/or pro bone dental care for the qualified veterans.

To qualify, veterans must be enrolled in VA for care, and must be non-eligible for VA Dental services. These non-eligible veterans may then be connected to community dental providers using one of two methods. In either method, all dental care is managed by the accredited community dental care providers. 

Method 1: The Cohort Method: The VETSmile team pulls names and addresses of Veteran Enrollees who are not eligible for VA Dental benefits. Based on capacity and input from the dental care partners, Veterans are contacted directly by CCPI, via email and mail, to notify them of their eligibility to participate in the VETSmile Program.  The veteran is also provided the contact information for the participating community dental provider. The Veteran would then reach out to that community dental care provider themselves and become that community provider’s established patient for any ongoing dental care needs. 

Method 2: The Referral Method: local VA Medical Center physicians refer patients to the community dental care providers through the Consult Toolbox.  The physicians would need to receive permission from the veteran to share their name and contact information with community dental providers so that they can be scheduled for dental care. There is no coordination of care, or approval of services by VA Dentistry VA Dentists, or VA Dental Clinics. 

The goal of this program is to connect non-eligible veterans with community dental care partners. As such, the program does heavily rely on referral by physician colleagues because they have a significantly higher interaction with non-eligible veterans than VA Dental services. In medical centers where this program has been deployed, it is being implemented through Primary Care. This pilot program has been authorized by Congress to run for 5 years. After 5 years, the results of the pilot will be evaluated, and a recommendation will be made to Congress as to what the future of the program should be.

This program should not be confused with the Community Care Dental program. The community care dental program is only available to those veterans who are eligible for VA Dental care, and VA will cover the cost of that care. Any costs associated with care provided under the VETSmile program are covered by the veteran (in the case of reduced fee care ) or by the community dental provider (in the case of pro bono care). 

As of February 2022, there are two VA Medical Centers and four dental community partners in the New York/New Jersey area participating in the program. These medical centers have connected over 1,000 non-eligible veterans with dentists in the community. CCPI is currently looking to expand this program across the country and enroll additional community partners with the end goal of providing veterans a “dental home” where they can continuously access affordable dental care.

NAVAPD’s Stance

NAVAPD believes that every veteran deserves access to quality dental care.  Given the eligibility requirements put in place by Congress, and the limitations on the ability to provide in-house dental care due to a severe shortage of dentists, lack of appropriate dental support staffing, lack of space to deliver oral health care, and lack of resources to adequately provide care to all veterans, this program provides an alternative to expand dental care access to non-eligible veterans that leverages community partners who can provide that care at a reduced low-cost or as pro bono care.  This prevents VA from relying on private practitioners who see the VA as a “blank check”.  NAVAPD supports the expansion of this pilot program nationwide to every VA medical center. Although we recognize the success of this program can rely on referrals from our physician membership, NAVAPD does not believe this additional consult will become burdensome.

NAVAPD also believes that if veterans are connected to quality oral health care early in their VA journey, ideally as they transition from DOD to VA, then as the veteran ages, and service-connected disabilities get adjudicated to a higher rating that would make the veteran dentally eligible, then the state of oral disease seen by VA Dentists may not be as severe as it currently is, nor be as labor intensive to correct as is currently. For the veterans we are honored to serve, this will then have an overall positive effect on their physical and mental health and consequently, holistically, we can improve the quality and quantity of life for our deserving veterans. 

NAVAPD would like to hear from you, our members, about your thoughts regarding the VETSmile program, especially if your medical center is currently participating. If your medical center is not participating, but would like to, you can contact us at opscoord@navapd.org  and we can put you in contact with the program administrator.

NAVAPD Leadership thanks you for all the hard work you do every day to improve the health and well being of our nation’s veterans.