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Wisconsin FQHC Partners with Area Dentists to Bring Care to the Underserved

July 17, 2014

A Federally Qualified Health Center in Wisconsin plans to expand a three-month pilot project in which it contracts with two local dentists who provide care to underserved residents.

As a Federally Qualified Health Center (FQHC), NorthLakes Community Clinic receives grant funding from the federal Health Services and Resources Administration and qualifies for cost-based reimbursements from Medicare and Medicaid, according to NorthLakes Chief Executive Officer Reba Rice. FQHCs are required to provide care for underserved populations and operate on a sliding scale fee schedule for patients who are at or below 200 percent of the federal poverty level. 

One of NorthLakes’ six health center sites, located in Ashland, is home to a three-month pilot project in which the center contracts with two local dentists, according to Ms. Rice. Only patients at 100 percent of the poverty level are eligible to receive treatment from those dentists, she added.

“Eventually we’ll be able to expand that so that the dentists who contract with us will accept patients at 200 percent of the federal poverty level, but right now we don’t want to overwhelm them until we’re sure they have enough openings in their schedules to meet those needs,” said Ms. Rice.

NorthLakes also plans to expand its dental services by contracting with a third dentist, and potentially more.

Dr. Jeff Nehring, a dentist based in Mercer who is also a Wisconsin Dental Association trustee, is one of the dentists who contracts with NorthLakes. 

“It’s nice to have a full spectrum of services ready for these patients,” he said. “We can take care of their basic dental needs, and if they need medical treatment, they can also receive that from NorthLakes.”

The health center pays the dentists a set rate for each dental visit, and there are a limited number of services provided by the dentists within the program. The rate is based on the center’s dental costs per visit, and excludes the costs of all services for medical and behavioral health issues addressed at the center.

“I’m really excited about this model involving contracting because I think it will be a win-win for patients, the health center and the dentists,” said Ms. Rice. “You have to have a really firm relationship between the FQHC and the private practice, because everyone needs to share very candidly what is happening.”

This isn’t NorthLakes’ first pilot project that involves contracting with local dentists. In 2011, the health center contracted with three dentists (including the two in the current pilot), who were paid per procedure, based on a percentage of the reimbursement rate of the Delta Dental PPO plan.

Ms. Rice said she believes that FQHCs contracting with private practice dentists is a way to improve access to care for people who normally wouldn’t receive it.

“What we really want to do is create a replicable model,” she said. 

The American Dental Association promotes collaboration among dentists and FQHCs because these contracts help safety net facilities expand their capacity to provide care to underserved populations without increasing the clinics’ “bricks and mortar” expenses and staffing overhead. 

Patients benefit because quality care can be quickly and efficiently delivered, alleviating much of the backlog experienced by many health center dental programs.