How health maintenance organizations prepared for the dental treatment reform for older adults in Israel

Background: The oral health of older adults in Israel is still worse than in many developed countries. In 2019, a Universal Health Coverage reform of dental services for older adults was initiated in Israel to improve their access to dental services and to mitigate some of the barriers they face, mainly the high cost. The aim of the study was to assess how the Health Maintenance Organizations (HMOs) prepared for the reform of dental treatments for older adults. Methods: Semi-structured telephone interviews were conducted with ten key figures and senior officials in the HMOs who were involved in the preparations to provide the dental services according to the new reform. Results: During the period prior to the reform, the preparations of the HMOs focused on training caregivers to treat older adults. With the implementation of the reform, HMOs began disseminating information about the new entitlements to dental treatments included in the basket of services to the target population. However, no significant organizational or infrastructure changes were made. Between 2019 and 2021, there was a moderate increase of about 10% in the number of patients treated in the HMO clinics. Conclusions: Essentially, the preparations by the HMOs were appropriate to accommodate the surge in demand due to the reform in its initial years.