ROANOKE TIMES
Copyright (c) 1997, Roanoke Times
DATE: Friday, April 4, 1997 TAG: 9704040095
SECTION: EDITORIAL PAGE: A-8 EDITION: METRO
SERIES: Second of two editorials
To improve the dental health of poor kids, the Medicaid reimbursement rate must be increased - and parents must show more responsibility.
DENTISTS are dropping out of participation in the state's Medicaid program faster than they can say ``open wide.'' Almost invariably, they cite as the reason the state's low reimbursement rate for their services.
Indeed, it's too low by half. The General Assembly should recognize the problem this creates for low-income children and take action to correct it, as state Sen. John Edwards of Roanoke proposed in the 1997 session.
The reimbursement is, on average, 43 percent of dentists' ``usual and customary rates.'' By contrast, physicians receive an average 91 percent of the usual and customary rate.
Moreover, dentists often have higher overhead costs than do other health-care specialties. The overhead differential is partly explained by the fact that dentists are more likely to have solo practices. As a result, a greater portion of their income goes to pay for support personnel, mortgages or rent, equipment, utilities, maintenance and the like.
When overhead is taken into account, dentists say, they can actually lose money when they treat Medicaid patients.
Medicaid payments to dentists account for about $10 million of Virginia's $2.3 billion Medicaid budget. In an effort to put dentists more on a par with physicians, Edwards sponsored a $20 million budget amendment this year to increase payments to dentists, but the Senate Finance Committee nixed it.
Meanwhile, hundreds of Virginia's Medicaid-eligible poor children are doing without dental care - including important preventive care that could save taxpayers money in the long run.
For example, the cost of early treatment for nursing-bottle decay - an affliction of many toddlers - is less than $1,000. Without early treatment, the children may require tooth extractions under general anesthesia, possibly in a hospital emergency room, at a cost of about $4,000.
Unfortunately, the reimbursement rate is not the only reason dentists are reluctant to take on Medicaid kids. Too often, parents don't see that the kids show up for appointments made for them. Or they bring other children in the family, expecting the dentist to see them all.
More parental respect and responsibility are also necessary to ensure dentists' participation in this program so vital to the health of children.
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