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Connecticut Leading the Charge to Improve Medicaid Dental Programs

April 16, 2014

Most state Medicaid dental programs fall well short of providing the amount and extent of care needed by their low-income beneficiaries.

Yet through a combination of fee increases and administrative reforms, Connecticut’s Medicaid program has transformed from dysfunctional to a model for other states, with the number of dentists accepting Medicaid patients jumping from less than 200 in 2008 to more than 1,800 last year, according to Carol Dingeldey, executive director of the Connecticut State Dental Association, which was instrumental in lobbying to improve the state Medicaid program.

“When we were lobbying for increased reimbursement rates, we testified that if the rates were increased, we would do everything we could to get the number [of providers] up to 400,” she said. “That was a huge challenge, just thinking about it.”

According to the Connecticut Health Foundation, nearly 70 percent of enrolled children had at least one dental visit per year, ranking the state second highest in Medicaid utilization among children.

Also, no child waits more than 24 hours with a dental emergency, according to Jim Williams, assistant executive director and government relations director of the state dental association.

In 2006, the dental association joined a coalition of healthcare advocates to form the Connecticut Dental Health Partnership, whose objective was to improve access to care by recruiting dentists to accept Medicaid. The group focused its outreach efforts on groups such as prenatal clinics, faith-based communities, Head Start, primary care physician offices, emergency departments, patients with special health care needs and those who don’t regularly visit the dentist.

The Connecticut State Dental Association’s board and officers were instrumental in recruitment efforts, becoming participants in the Medicaid program and urging their colleagues to do the same.

The state also adopted a single-payer system, meaning that participating dentists work only with one insurer, BeneCare, which obviates dealing with multiple administrative processes.

“[Previously] Our Medicaid dentists billed through several insurance entities, and each one had their own paperwork and administrative burden for the dentists to navigate,” said Mr. Williams.

Now, 99.4 percent of children on Medicaid have access to at least two dentists within two miles of their home, and the number of children with at least one dental visit per year increased from about 89,000 in 2008 to 171,000 in 2010, according to Ms. Dingeldey. More than 90 percent of Medicaid providers in Connecticut are accepting new patients.

“It definitely behooves us to have a robust Medicaid provider group,” she said.