STUDY SAYS RAISING REIMBURSEMENT FEES IMPORTANT TO INCREASING DENTAL CARE ACCESS
Policy Briefs Examine Connecticut’s Declining Oral Health Work Force and Potential Financial Strategies Designed to Expand Utilization of Oral Health Services Among HUSKY Children
NEW BRITAIN (January 27, 2006) – Raising Connecticut’s Medicaid reimbursement to the 70th percentile would increase utilization of oral health services among HUSKY children over time and, in the first year, cost the state an additional $21 million, which would be eligible for federal matching dollars, according to a series of two policy briefs released by the Connecticut Health Foundation Tuesday.
The first policy brief, entitled HUSKY A Dental Care: New Directions (PDF), outlines the barriers to providing dental care to the state’s more than a quarter of a million HUSKY A children and provides some potential solutions. The second brief, entitled HUSKY A Dental Care: Financial Strategies (PDF), examines the cost of increasing reimbursement fees so that a greater number of Connecticut’s dentist will participate in HUSKY and more children can receive services.
Currently, HUSKY A reimbursement fees are below the 7th percentile of fees in New England, according to Tryfon Beazoglou, policy brief series co-author and Professor of Dentistry at the University of Connecticut School of Dental Medicine.
“Partly because Connecticut’s fees are the lowest in our region, our dental utilization rates are also among the lowest, hovering around 30 percent among HUSKY A children,” said Beazoglou. “A declining oral health work force and a limited dental service safety net also contribute to our low utilization rates.”
The number of dentists expected to retire will exceed the number of new dentists expected to enter practice in the next 9 years, according to “New Directions.” By 2015 there will be a net loss of 391 dentists or 15 percent of the current work force of 2,591 dentists.
Options listed below could be combined to maximize the current dental care delivery system for low-income children:
Increasing the dental work force by enrolling more state residents in dental schools (state residents are more likely to practice in Connecticut after graduation);
Implementing a model dental program where a hygiene team provides screening and preventive services and coordinates with private dentists for restorative or other care;
Expanding the dental safety net capacity by improving productivity through the use of more dental auxiliary staff; and
Increasing Medicaid reimbursement fees to help increase dental care utilization.
“Raising the reimbursement fees to a level at which an adequate number of providers will participate in the Medicaid program is vital in expanding access to dental health care among the state’s most needy children,” said Joanna Douglass, “Financial Strategies” co-author and Associate Professor of Dentistry at UCONN’s School of Dental Medicine. “If the fee schedule is increased to the 70th percentile – which means that 70 percent of providers charge this fee or less -- we can expect that HUSKY kids will have access to 70 percent of all oral health providers in the Connecticut.”
Fee increases also will change the distribution of costs. The percentage of costs attributed to orthodontics will increase from 24 percent to 42 percent, a disproportionate increase given that less than 5,000 of the 267,949 children on HUSKY annually.
The co-authors recommend that all services except orthodontics should be increased to the 70th percentile at a total cost of approximately $37 million (state currently pays approximately $16 million + an additional $21 million) in the first year. In contrast if all fees were increased, including orthodontics, the total would reach around $56 million ($16 million + an additional $40 million) in the first year. All additional costs to the state would be eligible for federal matching dollars through the Medicaid program.
“If Connecticut is serious about increasing dental care utilization rates from 33 percent to 50 percent over the next several years, ongoing fee adjustments should be made to account for inflation,” said Douglass. “Annual fee increases for all dental services, including orthodontics, would prevent erosion of access to oral health care that has occurred since fees were last adjusted in 1993.”
Please visit www.cthealth.org to review both policy briefs or contact Monette Goodrich, VP of Communications & Public Affairs, at 860.224.2208, cell: 860 978 5130 or monette@cthealth.org. Goodrich also can schedule interviews with co-authors Beazoglou and Douglass.
The Connecticut Health Foundation (CT Health) is the state’s largest independent, non-profit grantmaking foundation dedicated to improving the health of the people of Connecticut through systemic change, program innovation and health policy analysis. Since it was established in July of 1999, CT Health has awarded 269 grants in 37 cities and towns totaling close to $21 million in three priority areas – children’s mental health, reducing racial and ethnic health disparities, and oral health.
