Many Maine Medicaid patients, often children, do not receive "adequate" dental care because some dentists will not accept them, NPR's "Morning Edition" reports. According to Burton Edelstein, founding director of the Children's Dental Health Project in Washington, D.C., "one of the biggest reasons" dentists will not see Medicaid patients is that reimbursements "typically aren't enough to cover the cost of care." Edelstein added that lack of transportation and other costs are also barriers to children enrolled in Medicaid receiving dental care. Edelstein said, "Federal studies show that overall, two-thirds to three-quarters of children obtain a dental service in a year. But in the Medicaid program, where the children have the greatest dental needs, it is only about one in four or one in five children who obtain a dental service in a year."
NPR reports that access to dental care for Medicaid patients is "worse" in rural states such as Maine, where there is a shortage of dentists because "the math doesn't add up for new graduates" from dental programs. Sheldon Wheeler, president of the Waterville, Maine-based Kennebec Valley Dental Coalition, which runs the not-for-profit Center for Community Dental Health in Portland, Maine, said, "You think of a private dentist coming out of school with a $200,000 student loan debt and another three-quarters of a million dollars to set up a practice; they are not going to be able to afford to see the Medicaid patient at that rate."
Discussing his clinic, Wheeler said, "Over the last thirteen months we have billed Medicaid $345,000. We have collected $150,000. That means that we are collecting 43% of what we bill for a center that has essentially no overhead." The Maine Dental Association is currently lobbying the state Legislature to follow South Carolina, Delaware and Indiana in raising the Medicaid reimbursement rate. Edelstein said this would be a "good first step" that has been shown to "substantially increase access to services." However, Edelstein added that there is also a need for more education about nutrition and dental care for Medicaid patients and better coordination between the physicians and dentists who treat them. The full report is available in RealAudio online at http://www.npr.org/ramfiles/me/20020103.me.ram (Chisholm, "Morning Edition," NPR, 1/3).
