Access to Medicaid Dentists
Although some poor people cannot afford dental care, others on Medicaid may not be able to locate a dentist that accepts their coverage (Hinton and Paradise 2016). Even though more people could get dental coverage in Medicaid, possibly leading to decreased visits to the “emergency rooms for dental problems, which is an expensive and ineffective source of seeking dental care,” they still need to find a dentist willing to accept Medicaid (Duff-Brown 2015; Singhal 2017). Patients still have a hard time finding dentists that accept Medicaid. Even though some dentists find Medicaid to be flawed, their clinics could operate well under Medicaid.
Despite the improvements to Medicaid, few dentists accept it, resulting in patients unable to obtain covered treatments and services. Many dentists do not accept Medicaid because of its “low reimbursement rates, administrative burden, and high no-show rates among Medicaid patients” (Hinton and Paradise 2016). Dental clinics’ employees have to devote more time to “the Medicaid credentialing and claims process” (Mayfield 2017). There have been efforts to improve access to Medicaid dental benefits, but low-income adults still cannot find Medicaid dentists. For instance, according to Robert Gebelhoff, “assistant editor for The Post’s Opinions section,” in 2014, while “around 8.3 million adults gained access to dental care” due to the Affordable Care Act’s expansion of Medicaid, “as of January 2013, about 45 million Americans were living in regions with shortages of dental care providers, especially in rural and urban areas” (2015). Although states such as Colorado, California, Illinois, Washington, and South Carolina “added or restored adult dental benefits” in 2014, dentists in those states were “struggling to keep up with demand” (Galewitz 2015). Based on a comparison between “2010 and 2014 data collected by the Centers for Disease Control and Prevention,” “1.5 million more low-income adults reported having a dental visit in 2014 than in 2010. However, among states expanding Medicaid that offer dental benefits there was a decline in usage among adults with children, who had enjoyed this access before the ACA’s implementation…” (Singhal 2017). Astha Singhal, “assistant professor with the Department of Health Policy and Health Services Research,” believes that since there had been no increase in dentists that could accept Medicaid, low-income childless adults and parents compete with each other to see those dentists for treatment (Singhal 2017).
Dental clinics can function well with Medicaid with the help of Dental Support Organizations (DSOs). DSOs take on several responsibilities involving Medicaid’s more time-consuming processes, such as its claims and billing procedures, that could help “dentists to focus solely on patient care…” (Mayfield 2017). Regarding reimbursements from Medicaid, DSOs also utilize “information technology platforms to better absorb low Medicaid reimbursement rates” (Mayfield 2017). Furthermore, DSOs help dentists keep their patients’ appointments by utilizing technology that “better [communicates] with their patients,” preventing lost income (Mayfield 2017).
Despite Medicaid dental coverage, people struggle to find a dentist. DSOs could help dentists manage Medicaid, allowing them to provide dental care to Medicaid patients without worrying about their earnings for their practice.