Ahmed Farag, State Dental Director at the Oregon Health Authority

Summary

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Podcast Summary

Episode Overview

Podcast: Becker’s Healthcare Podcast
Host: Ariana Portolattan
Guest: Dr. Ahmed Farag, State Dental Director, Oregon Health Authority
Date: September 20, 2025

In this episode, Ariana Portolattan interviews Dr. Ahmed Farag about the key challenges and opportunities in the dental industry, the movement towards recognizing oral health as essential care, and the evolving demands on healthcare leaders. Dr. Farag provides thoughtful analysis on workforce issues, payment reform, health equity, and the vital link between dental and overall health, sharing both optimism and caution about the future.

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Key Discussion Points and Insights

Dr. Farag’s Background and Philosophy

• International Perspective: Dr. Farag details his journey from dental practice in Egypt to health systems in Europe (Germany, Italy), and eventually to advanced training and leadership in the U.S.

  “Healthcare is a human right... shouldn't be depending on your geographic location, your income, or what kind of insurance you have.” — Dr. Farag [00:32]

• Personal Motivation: Inspired by his father and shaped by diverse healthcare systems, Farag emphasizes building smarter, equitable systems that meet individuals where they are.

Major Issues Facing the Dental Industry

• Disconnect Between Dental and Overall Health:
  • Dentistry often operates in a silo, relying on procedure codes, unlike medicine’s use of diagnostic codes, which limits integrated care and data sharing.

    “Oral health doesn’t exist in silo. It’s deeply connected to your whole body... But structurally, dentistry is often still separated from the data frameworks that guide medical care.” — Dr. Farag [02:24]

• Fee-for-Service Model and Equity:
  • The dental sector remains entrenched in fee-for-service, rewarding treatment over prevention, perpetuating inequities—especially in rural areas.

    “Dentistry remains mired in a fee for service model that rewards treatment over prevention or outcomes... almost 2/3 of the dental health professional shortage areas in rural communities where patients might have to travel hundreds of miles just for care.” — Dr. Farag [03:30]

• Access Disparities:
  • Rural and underserved populations face substantial access barriers, leading to delayed care, higher costs, and more suffering.

Optimism and Concerns About the Future

• Growing Momentum for Oral Health as Essential Care:
  • National policy is increasingly viewing dental care as essential, not optional—e.g., CMS expanding dental coverage tied to medical necessity, more inclusive Medicaid benefits.
  • Technological innovation and value-based payment pilots are beginning to address access for rural communities and integrate dental, physical, and behavioral health.

    “I’m incredibly excited by the national momentum around treating oral health as essential rather than optional.” — Dr. Farag [04:54]

• Cautions Ahead:
  • Financial pressures on government budgets may threaten recent gains, especially when dental benefits are seen as discretionary.
  • Policy changes risk becoming stagnant or symbolic unless supported by robust evidence and scalable implementation.

    “Without a strong evidence-based case for the value and cost effectiveness of dental coverage specifically, these advances… could stall or even regress.” — Dr. Farag [06:50]

  • Ensuring new models are equitable and truly improve lives requires alignment of incentives and stronger provider networks.

Leadership Qualities Needed for the Future

• Strategic Clarity:
  • Leaders must balance policy reform, technological advances, workforce shortages, and rapid change, focusing on value for patients and communities.
• Hybrid Skill Sets:
  • The best leaders blend clinical credibility with business and public health expertise—an ability to understand on-the-ground realities and drive organizational change.

    “Clinician leaders who understand the realities of patient care can also analyze data, budgets and lead organizational change. They are uniquely positioned to drive transformation.” — Dr. Farag [08:54]

• Adaptive Leadership:
  • Effective leaders pivot quickly, analyze rapidly changing data, and make equity-driven, evidence-based decisions.

    “Adaptive leadership is really the separation between who manages the change and who drives it.” — Dr. Farag [09:43]

• Equity and Trust:
  • True progress depends on embedding equity in all strategies and building trust with communities, providers, and policymakers.
• Collaborative Vision:
  • It’s crucial for all stakeholders—clinicians, policymakers, patients—to contribute to building more equitable and integrated health systems.

    “The policies and systems we build today will shape health outcomes for generations in the future... We have a role to play here in advancing for more equitable and integrated health systems.” — Dr. Farag [11:23]

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Notable Quotes & Memorable Moments

• On Healthcare Philosophy:

  “At my core, I believe healthcare is a human right. It is a fundamental need that shouldn't be depending on your geographic location, your income, or what kind of insurance you have.” — Dr. Farag [00:32]

• On Integration of Dental and Physical Health:

  “Oral health doesn’t exist in silo... But structurally, dentistry is often still separated from the data frameworks that guide medical care.” — Dr. Farag [02:24]

• On Fee-for-Service Model:

  “Dentistry remains mired in a fee for service model that rewards treatment over prevention or outcomes.” — Dr. Farag [03:55]

• On Optimism for the Future:

  “Years of advocacy are finally paying back and we are starting to see some conversions into tangible, scalable models for change.” — Dr. Farag [05:56]

• On the Need for Evidence and Policy Strength:

  “Without a strong evidence based case for a value and cost effectiveness of dental coverage specifically, these advances that we have gained could stall or even regress.” — Dr. Farag [06:50]

• On Equity as a Leadership Imperative:

  “Equity and trust will define the leaders of the future. It’s no longer enough to just talk about reducing disparities. The expectation now is that leaders embed equity into everything they do.” — Dr. Farag [10:40]

• On Collaboration for Systemic Change:

  “Every one of us, whether we are a clinician, a policymaker, a patient, we have a role to play here in advancing for more equitable and integrated health systems.” — Dr. Farag [11:30]

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Timestamps for Key Segments

• [00:32] Dr. Farag’s Background & Philosophy on Healthcare
• [02:24] Disconnect Between Oral and Overall Health; Data Challenges
• [03:30] Fee-for-Service Model and Rural Health Access
• [04:54] Optimism: Treating Oral Health as Essential; Technological Innovations
• [06:50] Concerns: Budget Pressures, Evidence, and Implementation Risks
• [08:32] Essential Qualities for Future Healthcare Leaders
• [10:40] Role of Equity and Trust in Leadership
• [11:23] Call for Continued Collaboration and Shared Responsibility

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Tone and Language

Dr. Farag’s tone is reflective, optimistic yet realistic, and emphasizes social responsibility, coalition-building, and the urgent need for policy-driven, systemic change in oral health. His language is inclusive, visionary, and grounded in both personal experience and systemic analysis.

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This summary provides a comprehensive overview for listeners who want the key ideas, leadership insights, and policy directions discussed by Dr. Ahmed Farag, while highlighting memorable quotes and important context for the evolution of dental care in the U.S.

Transcript

[A]

Hello, this is Ariana Portolattan with the Beckers Dental and DSO Review Podcast. I'm thrilled to be joined today by Ahmed Farag, the oral Health Director for the Oregon Health Authority. Ahmed, thank you so much for being here today. It's great to have you.

[B]

Thank you, Arianna. Thanks to Bickers for having me. It's an honor to be on the podcast and I have listened to so many great leaders here and truly admire the work you're doing.

[A]

Yes, we're happy to have you here to start us off. Can you introduce yourself for our listeners and tell us a little bit about your background and your work with the Oregon Health Authority?

[B]

Yeah, sure. I'm Dr. Ahmed Farag, and at my core, I believe healthcare is a human right. It is a fundamental need that shouldn't be depending on your geographic location, your income, or what kind of insurance you have for a background. My journey really started with my father, a retired surgeon, who was my first role model for providing intentional human care. My path has been edifying, and you can call it uniquely not straight. I began my dental and surgical career in Egypt, where I often cared for patients who have been overlooked by a system with very few resources. I then had the opportunity to work in advanced universal health systems in Europe, specifically Germany and Italy for a few years. That opened my eyes to the incredible potential of truly accessible healthcare. I then came to the University of Rochester, New York, over a decade ago, where I advanced my dental training at the Eastman Institute of Oral Health and Strong Memorial Hospital, while also earning my master's from the Simon Business School. All of these steps have led to my current role here at Oregon Health Authority, and I'm here to build smarter systems that meet people where they are and give them a fair and equitable chance at better health. It drives me so much every day knowing that every policy we shape, every partnership we build, can make real difference in someone's life.

[A]

Great. Thank you so much for sharing your background there. It's good to hear. First question for you here. What are some of the biggest issues that you're following in the dental industry currently?

[B]

Yeah, thank you for saying the biggest issues. Understanding that oral health is faced with many of the same challenges that the rest of healthcare are faced with. But some of the most depressing issues that I'm focused on right now is the persistent disconnect between oral health and overall physical and mental health. Unlike the medical counterparts, most dentists still rely heavily in their communication on procedure codes alone. This is missing the rich clinical context that diagnostic codes like ICD 10 or probably soon 11 would offer. This gap limits our insights into the connection between oral health and systemic condition and prevents oral health providers from speaking a unified, data driven language with payers, partners and policymakers. The fact is, oral health doesn't exist in silo. It's deeply connected to your whole body. It's connected to chronic diseases like diabetes, cardiovascular diseases, maternal health and even child and adolescent academic performance. But structurally, dentistry is often still separated from the data frameworks that guide medical care and fixing that disconnect, truly having an integrated models is one of the most important opportunities we have to transform care. Not to say as well that we are still navigating the long shift from volume to value. Dentistry remains mired in a fee for service model that rewards treatment over prevention or outcomes. This is creating major inequities really and on an equity side of things, according to HRSA data, almost 2/3 of the dental health professional shortage areas in rural communities where patients might have to travel hundreds of miles just for care. These barriers, in addition to the poverty geographic isolation, mean that many people don't get care until a condition is severe. This would drive our costs up and causes a lot of avoidable suffering for our population.

[A]

Okay, yeah, some good points that you share there, so thank you for that. Our next question here for you. What are you most excited about when it comes to dentistry and what makes you nervous?

[B]

I have a healthy mix of optimism and realism about that question and about the future. My optimistic side is incredibly excited by the national momentum around treating oral health as essential rather than optional. So you can see at the federal level, CMS and HHS have opened important doors for states to have the opportunity, including dental care as essential health benefit. And on the Medicare side compared to previously now, CMS has taken meaningful steps to expand coverage for dental care that is inextricably linked to medical care like oncology, cardiac interventions and chronic renal disease end stage renal disease for the Medicaid. On the Medicaid side as well, we can see that multiple states have, including Oregon, offer comprehensive adult dental coverage and more states are expanded. So these are all incremental changes that represent a huge cultural and policy shift towards seeing oral health as a fundamental part of the oral health. I'm also energized by really the pace of innovation we have in the industry and we are seeing value based payment pilots, technology solutions that expand care for rural communities and partnerships that truly integrate dental, physical and behavioral health. And it feels like the years of advocacy are finally paying back and we are starting to see some conversions into tangible, scalable models for change. But with all that excitement, I have to be realistic. There are some serious headwinds, financial pressures on the government budgets that we are seeing. And health systems also have financial pressures. These are intense and the history has told us that benefits treated as optional are usually pressured when budgets tighten. So without a strong evidence based case for a value and cost effectiveness of dental coverage specifically, these advances that we have gained could stall or even regress. I'm also concerned about the equity part and the scalability. Our policy changes for as pilot programs and so on are really important. But unless we align some of our incentives and strengthen provider networks, simplify administrative process, these advancements could risk staying on paper instead of improving lives. So at the end I would say I describe my outlook as deeply optimistic but deliberately cautious.

[A]

Yeah, I think that's very similar to what many other dental leaders are feeling right now. Are you concerned at all with some of the Medicaid cuts that could come from the the new federal budget?

[B]

I think it's not only me. As you said, everybody is concerned. Anytime you can constrain the budget or decrease your spending, you risk probably taking away some of the advantages and advances that you have done at least. Also, if you are not taking anything back, you could stall your progress and the momentum that you had over the past year. So yes, I would say definitely a concern there.

[A]

Okay, and what some of the things you mentioned in mind, what will the most effective healthcare leaders need to be successful in the next two to three years?

[B]

That's a great question. The next few years are really going to demand a different kind of healthcare leadership. Leaders who are visionary, strategic and ready to navigate unprecedented complexities. I believe there are four key things leaders would need. First, strategic clarity will be essential. Between a policy reform and value based models and workforce shortage, rapid technological disruptions, budget changes, leaders would really need to cut through the noise and focus on strategies that create measurable value for patients and communities. And second, we will need leaders with hybrid skill set. People who bring clinical credibility, but also advanced expertise in business, public health or change management. Clinician leaders who understand the realities of patient care can also analyze data, budgets and lead organizational change. And they are uniquely positioned to drive transformation. I have seen this personally. My clinical background gave me insights to understand how patients and providers act and react and what they need. But pursuing some advanced training in business or healthcare leadership gave me the tools to translate this into straight insights into strategic executions. The third here would be adaptive leadership. And I say this usually in My talks adaptive leadership is really the separation between who manages the change and who drives it. So we are in an era where economic pressures, policy shifts, some public expectation can change overnight. And the leaders who will succeed are those who can pivot quickly, interpret data intelligently, and make decision grounded in both equity and evidence. The final thing, and I'll double down on equity here and trust will because equity and trust will define the leaders of the future. It's no longer enough to just talk about reducing disparities. The expectation now is that leaders embed equity into everything they do, from strategic planning to budgeting to perform design to program design. And building trust with communities, providers and policymakers will be the currency for sustainable change. Leaders who engage authentically and communicate transparently will be able to navigate these next years and shape the future. My final thought is really we can't afford to be complacent. The policies and systems we build today will shape health outcomes for generations in the future. Every one of us, whether we are a clinician, a policymaker, a patient, we have a role to play here in advancing for more equitable and integrated health systems. The work is hard, but it's more important now than ever. It's a journey we're all on together and I'm really grateful to be part of that.

[A]

Thank you so much for sharing that. It's great to hear about your philosophy on healthcare leadership there and what you're paying attention to. Thank you so much. That's all I have for you today. Thank you so much for joining us again. It's been a pleasure speaking with you and I'm looking forward to connecting with you again in the future.

[B]

It has been my pleasure being here and look forward to our next communication. Thank you.

[A]

Thank you. Bye bye.