Reimbursement issues and processes could be keeping some dentists from joining the programs as providers, according to Hollie Stevenson, the vice president of affiliate and government relations at Dental Lifeline Network.
Ms. Stevenson recently joined the Becker's Dental + DSO Review podcast to discuss the trends she is following in dentistry, workforce issues and dental care under Medicaid and Medicare.
Editor's note: Responses were lightly edited for clarity and length.
Question: What are some of the biggest issues you're following in dentistry right now?
Hollie Stevenson: [One of the issues] we continue to follow are Medicaid and Medicare dental benefits, primarily the Medicaid dental benefits and the type of coverage states provide through their programs. We've seen an expansion of state benefits. However, the reimbursement rates in most of those states have not kept up with actual costs, and it'll be interesting to see how people being removed from Medicaid will really impact our programs, and how many will need treatment through our programs. Since Medicare does not include dental benefits, we are seeing an increase in seniors needing our services, and although Medicare started reimbursing for some dental care related to other medical issues, dentists may not actually want to become a Medicare provider. We find that some of our volunteers tell us they'd rather work with our program and provide pro bono work than become Medicaid or Medicare providers.
Q: Why might some dentists not want to become Medicaid and Medicare providers?
HS: We've heard there are a couple of reasons. One, to become a Medicaid provider, you have to be certified through a state agency. Secondly, depending on the state, some of the reimbursement rates are very low. What we've heard is sometimes it's a hassle to become a Medicaid provider, so they would rather just not do that. I've even heard of some dentists who, what they're doing is they become Medicaid providers, but they have to really balance that with their private insurance patients just because they're being under paid through Medicaid. Medicare is just a small niche and it has to do with those patients who are undergoing another medical condition and that's why they would be eligible for some services through Medicare. I have seen historically where oral surgeons might be Medicare providers, but it's more of a niche if they would want to be certified through Medicare.