Newswise — Amid growing concern that state budget crises will turn back the clock on gains in children's access to oral health care, a new report from the American Dental Association (ADA) provides surprising results from a first-ever checkup of state dental Medicaid programs.
ADA President T. Howard Jones, D.M.D., says the report is cause for both hope and dismay. "States have struggled valiantly to improve access to dental care, but budget deficits are straining Medicaid and State Children's Health Insurance Program (SCHIP) resources, threatening the achievements made on behalf of our nation's neediest children," he said.
The report, State Innovations to Improve Dental Access for Low-Income Children: A Compendium, is a compilation of data drawn from each state's Medicaid and State Children's Health Insurance Program and addresses areas dentists have long identified as barriers to care: Medicaid financing, program administration, and patient compliance and awareness.
Although national statistics indicate just one in four Medicaid-enrolled children receive any dental service under Medicaid, some states have developed unique public-private partnerships and strategies that can serve as models for other states seeking to provide dental services to low-income children. These homegrown programs show a remarkable return on a minimal investment.
Alabama literally called out their National Guard to mobilize dental units to deliver oral health care to school-age children in Medicaid by setting up tents on the playgrounds of elementary schools throughout the state.
Georgia dentists, to promote state efforts to improve the Medicaid program, initiated a campaign called "Take Five," asking every dentist to accept five new Medicaid patients each year.
Michigan set up a 37-county pilot program through the Delta Dental Plan of Michigan to improve dentist participation in Medicaid and access to care for low-income children. Increasing reimbursement rates to marketplace levels, issuing private insurance-like membership cards to enrollees and adjusting billing procedures to mirror private insurance procedures, the "Healthy Kids Dental" program has increased dental visits to 44 percent from 18 percent of eligible children, and increased by more than 300 percent the number of dentists participating in the program.
According to ADA Executive Director James B. Bramson, D.D.S., "When it comes to improving access to care, there is no 'one size fits all' solution. We need continued leadership at the state level and partnerships between policymakers and the dental community to build on the successful programs described in State Innovations to Improve Dental Access for Low-Income Children: A Compendium. The ADA hopes that states will use this report to learn from each other how to improve access to oral health care in cost-effective, non-bureaucratic ways."
The report provides states with a tool to compare for the first time Medicaid reimbursement rates for children's dental services with dental marketplace rates across their region. One of the major stumbling blocks to dentists' participation in the Medicaid system is the failure of many states to cover even the basic cost of providing dental care.
Unlike hospital-owned physician offices, which spread costs among many facilities in their network, dental offices are primarily small, stand-alone businesses with 55-65 percent of their revenues paid out in overhead costs, depending on the location. These costs are for staff, equipment and materials.
The report focuses on the many ways states have sought to address other access barriers highlighted by dentists and advocates: eliminating prior authorization requirements for treatment, providing swipe-card readers to determine patient eligibility, issuing incentives to attract dentists to practice in underserved communities, and having social workers and other providers educate patients about oral health and arrange for transportation to a dental office.
"These programs and others throughout the country can spark new ideas for states struggling to improve access to oral health care with limited resources," Dr. Jones said. "Last February, the American Dental Association launched the national Give Kids A Smile/National Children's Dental Access Day, which provided free dental services and products valued at some $100 million to an estimated one million disadvantaged children while also drawing attention to the epidemic levels of untreated dental disease. The State Innovations to Improve Dental Access for Low-Income Children: A Compendium report provides a checkup on the oral health services provided to Medicaid-eligible children across the country. It's a reminder both of the ongoing need and of what creative people can accomplish to meet that need, even when money is tight. The ADA and its members are committed to working toward common sense, market-based state programs so needy children won't suffer from untreated dental disease."
The not-for-profit ADA is the nation's largest dental association, representing more than 147,000 members. The premier source of oral health information, the ADA has advocated for the public's health and promoted the art and science of dentistry since the 1859. The ADA's state-of-the-art research facilities develop and test dental products and materials that have advanced the practice of dentistry and made the patient experience more positive. The ADA Seal of Acceptance long has been a valuable and respected guide to consumer and professional products. For more information about the ADA, visit the Association's Web site at http://www.ada.org.
Editor's Note: To access State Innovations to Improve Dental Access for Low-Income Children: A Compendium, please visit http://www.ada.org and click the link to the report under "News and Features."
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