KHI News Service
Aug. 1, 2011
"TOPEKA — The Kansas Dental Association announced today an initiative to get 140 more dentists signed up as Medicaid providers and start accepting patients.
In Kansas, children 18 and under are eligible for dental coverage under Medicaid. However, only 350 of the state's 1,425 dentists treated at least one Medicaid patient last year, according to the KDA.
About 129,000 children received oral care through the Medicaid program between July 2010 and June 2011 — an average of more than one Medicaid patient per day for the dentists who accept them.
KDA director Kevin Robertson said there's a certain "Medicaid lore" among dentists that keeps most of them from accepting patients. He hopes that the Medicaid 140 Initiative — which will consist of events around the state and other communications to dentists — will help convince some dentists to at least give it a try.
"We think many dentists will listen, though 140 is an ambitious number," Robertson said.
"We're encouraging dentists to just give it a shot. Do a couple Medicaid patients, send in your claim forms, get paid and then take on a few more — just ease into the system," he said.
"We can't rely on a few dentists to do the lion's share of the Medicaid work, especially at a time when there's more and more Medicaid patients being put into the system," Robertson said.
Incentives
KDA has limited tools at its disposal to encourage dentists to accept Medicaid patients.
Currently in Kansas, Medicaid reimburses at 56 percent of a dentist's usual fee. Robertson said dentist offices average about 60 percent overhead costs, so some dentists actually lose money when seeing Medicaid patients.
Robertson said the KDA continues to work with Gov. Sam Brownback's office and legislators to raise the reimbursement rate, but he said that's a tough sell amid Medicaid budget concerns.
The same goes for extending oral coverage to all Medicaid-eligible adults. KDA asked the legislature to do so this year as part of its plan for addressing the state's dentist shortage, but then removed the Medicaid provision because legislators labeled it "dead on arrival," Robertson said. He said the health reform law will increase the share that the federal government pays in 2013, so the KDA plans to re-introduce the proposal then.
Robertson said other states, such as Oklahoma, have implemented tax credits for dentists who accept Medicaid, but Kansas has not pursued that route yet.
'Put up or shut up'
Dr. Susan Hall has been a dentist in Lawrence for 16 years and in Arizona for nine years before that. Hall, who has accepted Medicaid patients for all 25 years, said she's not sure how many Medicaid patients she has now — she doesn't want to know who they are to avoid biasing decisions she makes about care.
That said, Hall's office staff keeps the percentage at a certain rate her practice can afford.
"The state pays such a limited amount," Hall said. "The way they budget things, they actually pay less than most insurance will, and it barely covers the cost of seeing the patient. But I feel like underprivileged children should have the same quality of care as other people. They can't help it that they can't afford the care."
She said one incentive for dentists to accept Medicaid patients is the proposed mid-level dental practitioner. The KDA opposes allowing so-called mid-level practitioners to do basic procedures currently done only by dentists in Kansas.
Advocates have supported licensing mid-level practitioners in Kansas as a way to expand oral care access for Medicaid and uninsured patients.
For her part, Hall doesn't really support the mid-level practitioner concept — but she said, it would be better than some Kansans going without care at all.
"If dentists don't take on that role of being Medicaid and Medicare providers, they're going to push the state into accepting that kind of provider," Hall said, referring to mid-level dental practitioners.
"It's time to put up or shut up," she said."
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