Medicaid Questions & Answers

Why do we need an increase in Medicaid reimbursement for dentists?
    * Access to care for indigent kids, the elderly, and developmentally delayed patients is hampered due to declining participation by dentists.  Surveys nationally and statewide show that low fee reimbursement below the cost of providing the services is the primary reason dentists do not participate in Medicaid.  The state spends about $10 per month per Medicaid-eligible for dental care compared to $32 per month that state employees pay through the state’s market-based dental insurance plan.

    * Increasing the ability of Medicaid patients to find dental homes saves money.   

          o Studies have shown that visits to hospital Emergency Rooms in ND have been increasing for Medicaid dental patients in the last few years, as access deteriorates.  This increases the overall cost of care for these patients as no definitive dental care can be provided in hospital ER's.

          o Future dental costs for children who receive regular preventive visits early in life are 40% lower than costs for children who receive care after years of neglect (CDHP Brief- February 2005).

If Medicaid reimbursement for dentists is increased, how can we be sure that access to dental care will increase and this will not just be something that benefits dentists?
    * An increase in Medicaid reimbursement is about the indigent elderly patients, developmentally-delayed patients, and poor kids that cannot currently get care.....it is not about dentists. Dentists feel a moral obligation to advocate for these patients...if they don't, who will?  

    * Dentists currently donate services in many ways through public health programs and charity care.....access to care has been mission #1 for the North Dakota Dental Association for the last 15 years.  Isn't it time the state is a partner in this effort?

    * Although the NDDA cannot guarantee improved access, a budget increase in future legislative sessions would be based on national precedent.  The NDDA will work to educate and inspire North Dakota dentists to increase their participation in the Medicaid program. 

Why should dentists receive more of an increase than other providers?
    * Access to dental care is considered a crisis in our state by other professionals.....physicians, Head Start teachers, DD providers, and public health advocates. 

    * Dentists have higher overhead than most other providers, generally work as solo practitioners with no ability to cost-shift, and are better engaged in finding solutions to access problems, through our participation in charitable programs and advocacy.