Navigation Links
Some Dentists Reluctant to Treat Kids on Medicaid: Study

By Maureen Salamon
HealthDay Reporter

MONDAY, May 23 (HealthDay News) -- Undercover research in Illinois reveals that dentists are far more willing to provide emergency care to children with private insurance than to kids with public insurance such as Medicaid.

Posing as mothers of a fictional 10-year-old boy with a fractured front tooth, six research assistants phoned 85 dental practices twice, four weeks apart, to determine the impact of insurance status on the practices' decision to schedule an urgent dental appointment.

Even when calling Medicaid-enrolled dentists, just 68 percent of children with the Medicaid/Children's Health Insurance Plan were able to get an appointment, compared to all of the privately insured children. Non-enrolled dentists offered an appointment to only 7 percent of kids with public insurance despite the fact that Medicaid reimburses all emergency dental care.

"That's a huge difference," said study co-author Dr. Karin Rhodes, director of the division of emergency care policy research at the University of Pennsylvania's School of Social Policy and Practice. "This gives irrefutable numbers. I think there's a real disparity between oral health and traditional medical care in this country."

The study was published online May 23 in the journal Pediatrics.

A fractured front tooth is an urgent, common childhood injury with long-term implications, Rhodes said, including infection, pain and cosmetic problems. Traumatic injuries to permanent front teeth affect one in seven pre-teen children, but more than 10 percent of significant dental fractures go untreated, according to the study.

Nearly half of the randomly selected dental practices called by the researchers were enrolled in Illinois' combined Medicaid/CHIP dental program. In 170 paired calls to both types of practices, a total of 36.5 percent of Medicaid beneficiaries obtained an appointment, compared with 95.4 percent of children privately insured by Blue Cross.

Rhodes blamed the disparity on Medicaid's reimbursement rates to dentists. In Illinois, Medicaid reimburses dentists 53 percent of their median usual fees, placing the state among 25 others below the national average reimbursement level of 60.5 percent for the same procedures, she said.

"I think many dentists shy away from emergency care because they have to follow up" when they know they may not be equitably reimbursed, Rhodes said. "I also found it disturbing a lot of dentists who turned down patients ... said they were willing to see the child if the mother would pay cash."

"I'm very sympathetic to the state," she added. "Illinois is not alone -- I think they're probably in better shape than a lot of places. I think this has implications for a lot of states. It's definitely a wake-up call."

The president of the American Dental Association, Dr. Raymond F. Gist, said the study supports the ADA's longstanding position that better funding for public-assistance programs is critical.

"Lack of funding is among the greatest barriers to better oral health in America," Gist said. "But funding alone will not 'fix' Medicaid. Patients need help navigating an often complicated bureaucracy and overcoming other barriers."

When Medicaid reimbursement rates reach levels that a majority of dentists consider acceptable, participation and utilization increase dramatically, Gist said, citing an ADA analysis of state children's Medicaid programs developed in 2003 and updated in 2009.

"This is a tipping point, rather than a steady-scale phenomenon," he said.

Dr. Burton Edelstein, a professor of dentistry and of health policy and management at Columbia University in New York City, said that despite the study's "disappointing" findings, the problem is beginning to get noticed nationally and a Medicaid group is focusing on a solution.

"The study does typify the problem, but it's getting significant attention," said Edelstein, also president of the Children's Dental Health Project in Washington, D.C. "I'm forever optimistic that the structural changes we're seeking to make in the program will result in greater access to care."

Parents with public insurance who are turned away at a dental office can ask their primary-care physician for guidance or consult local dental schools, which often offer emergency dental care, Rhodes suggested.

More information

To learn more about dental care for children, visit the U.S. National Library of Medicine.

SOURCES: Karin Rhodes, M.D., director, division of emergency care policy research, department of emergency medicine, School of Social Policy and Practice, University of Pennsylvania, Philadelphia; Raymond F. Gist, D.D.S., president, American Dental Association; Burton Edelstein, D.D.S., M.P.H., professor of dentistry and of health policy and management, Columbia University, New York City, and president, Children's Dental Health Project, Washington, D.C.; May 23, 2011, Pediatrics, online

Copyright©2010 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. Top New York Dentists at Smile in the City Launch New Web Site
2. Union of American Physicians and Dentists: Does UC Vice President Stobo Stand to Profit From Corrections Healthcare Deal?
3. San Diego Cosmetic Dentists Launch New Website and Rejuvenate Online Image
4. LASIK Surgeons, Plastic Surgeons, Cosmetic Dentists and other Cash Paid Medical Specialists Brought Together for Groundbreaking Webinar Series
5. Muscle Angel Massagers™ Receive Accolades from Dentists and Hygienists
6. Tongue measurements may help dentists determine oral appliance therapy success for sleep apnea
7. Questionnaires help dentists screen for sleep-disordered breathing in children
8. Pilot safety protocol could help dentists reduce errors
9. Study shows physicians reluctant to use chemoprevention for prostate cancer
10. Enhancing arrest of cell growth to treat cancer in mice
11. Despite Treatment, Employees with Depression Generate Higher Absentee Costs, According to Thomson Reuters Study
Post Your Comments:
(Date:11/27/2015)... (PRWEB) , ... November 27, 2015 , ... ... of the well-respected Microsoft Dynamics SL User Group (MSDSLUG). Recognized as Microsoft’s official ... independent group of Microsoft Dynamics SL software users, partners, industry experts and representatives. ...
(Date:11/27/2015)... ... November 27, 2015 , ... The moment ... itself for not only fulfilling the needs of advisers and clients but going ... price and providing top-tier customer service. However, there's always room for improvement, which ...
(Date:11/27/2015)... ... 27, 2015 , ... CBD College is proud to announce that ... awarded accreditation to its Diagnostic Medical Sonography program. CBD College is honored to join ... twelve colleges and universities in the state of California make the cut. CBD College ...
(Date:11/27/2015)... (PRWEB) , ... November 27, 2015 , ... Dr. ... Medical Associates, Inc. and Dr. Tucker Bierbaum with Emergency Medicine at St., ... observed that both STEMI and Sepsis conditions present in similar ways and require time-critical ...
(Date:11/27/2015)... ... , ... Indosoft Inc., developer and distributor of the world-class ... (Long Term Support) into its Q-Suite 5.10 product line. , Making the change ... version of Asterisk that will receive not only security fixes, but feature and ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... Nederland, November 26, 2015 ... Een nieuwe aanpak combineert immunotherapie met Bremachlorin-photodynamische ... ) --> ...      (Photo: ) ... Universitair Medisch Centrum (LUMC) blijkt ...
(Date:11/26/2015)... -- 3D bioprinting market is expected to ... report by Grand View Research Inc. Rising prevalence of chronic ... transplantation is expected to boost the market growth, as 3D ... --> 3D bioprinting market is expected to ... report by Grand View Research Inc. Rising prevalence of chronic ...
(Date:11/26/2015)... DUBLIN , November 26, 2015 ... has announced the addition of the  ... in the Global Cell Surface Testing ... Opportunities" report to their offering.  ... the addition of the  "2016 Future ...
Breaking Medicine Technology: