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Michigan dentists fill in gap

Okemos, Mich.—Many Michigan dentists are filling in the access to care gap between what patients can afford and what Medicaid provides by donating thousands of dollars each in care, the Michigan Dental Association reported.

The MDA commissioned a study from Marketing Resource Group Inc., which surveyed 990 dentists across the state to help the dental society quantify the amount of free or discounted care their members provide to uninsured and underinsured people. Surveyors asked the dentists, who are all MDA members, their impressions of public dental health in Michigan, their perceptions of the state Medicaid program and for quantitative data to show what they are doing to create better access to care for those in need.

"We're trying to get the word out to the public that dentists are doing a lot, and we're doing a lot more than what the government is doing sometimes," said Dr. Jeffery Johnston, MDA president. "The point of the study was to get an approximate dollar amount of services individual dentists are providing annually to address the access problem. At times, this can exceed what the government is providing. Charity is not a form of health care."

Ninety percent of the dentists surveyed donated an average of $62,000 each; $45,000 of which was provided by the dentist and $17,000 by dental staff employed by the dentist, the MDA said. Fifty-five percent of the discounted care was for more expensive restorative services such as crowns or fillings; 16 percent was for oral surgery; and 7 percent was for preventive care.

"Most believe that poorly funded programs like Medicaid—created to improve access to care—are actually limiting access because of their low provider reimbursement rates," the report said. "Therefore, oral health practitioners in Michigan are taking it upon themselves to create better access, apart from the government-run programs."

Dr. Johnston said the MDA plans to share the findings with Michigan legislators in hopes of sparking a conversation about spending more on Medicaid. Michigan's Medicaid program covers 40 percent of the cost of providing dental care, according to the MDA.

Sixty-two percent of dentists surveyed said insufficient funding of government programs was the primary reason uninsured and underserved patients can't get dental care. Another 26 percent said the main cause was the widespread lack of understanding about the importance of oral health.

"Charity cannot be a health care system," Dr. Johnston said.  "Michigan dentists are trying to address the access problem as effectively as possible but it becomes unsustainable when government programs designed to achieve that goal are not adequately funded. We don't need more providers, we need a more adequate system for covering the actual cost of care."

Dr. Johnston and the MDA said they applaud Michigan Gov. Rick Snyder for supporting the expansion of the state's Healthy Kids Dental program for children in Medicaid-eligible families. The program reimburses dentists at rates similar to those in private insurance. Eighty-one percent of Michigan dentists participate in Healthy Kids Dental.