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Action for Dental Health

Milwaukee Community Partnership Improves Access to Dental Care

July 31, 2014

Thanks to a community-wide health care partnership in Milwaukee, people seeking relief from dental pain in the emergency rooms at eight area hospitals are getting the care they need from dentists in community health centers, free clinics and private dental practices.

But that wasn’t always the case. 

In 2006, health system executives noticed a worrying trend: like many other hospitals throughout the country, Milwaukee’s emergency rooms were inundated by people who weren’t there for emergency medical conditions. 

In 2009, 48 percent of emergency room visits in Milwaukee County were classified as non-emergencies, according to the Milwaukee Health Care Partnership. Nearly two thirds of those patients were uninsured or covered only by Medicaid. 

The Milwaukee Health Care Partnership developed the Emergency Department Care Coordination initiative to connect Medicaid and uninsured patients with non-emergency needs to primary care medical homes. The partnership comprises the city’s five healthcare systems, four Federally Qualified Health Centers, the Medical College of Wisconsin, as well as city, county and state health departments.

More than 30,000 referrals have been made since 2009, with a 44 percent decrease in subsequent ER use for those patients who kept their appointments. In 2013, the program was expanded to include dental referrals.

Dentists participating in the pilot say the model has proven successful, thanks in no small part to an online appointment system in which hospital personnel create referrals to the dentists, according to Dr. Monica Hebl, who practices at Burleigh Dental Clinic and treats people referred to her clinic by area emergency rooms.

“The online appointment tool makes the referral process so much easier because you don’t have to call anybody, you just log in and you manage it yourself,” she said. “You see it in real time.”

Last year, more than 500 people were referred to area dentists. But to the frustration of the program’s organizers and participating dentists, referrals don’t always translate to patient care.  

Dr. Roberta Kerr is a staff dentist at Milwaukee Health Services Inc.’s MLK Heritage Health Center, a participating FQHC.

“One of the biggest issues we face is an inability to get ahold of the patients to remind them of the appointment,” she said. “Once they get their antibiotics from the ER and they’re out of pain, some people decide not to show up at the dentist’s office.”

According to Dr. Kerr, a majority of the people referred to her office are eager to receive treatment.

“They wait to seek treatment until they are in pain, which is why they show up at the emergency room in the first place,” she noted. “But far too often, emergency rooms aren’t equipped to treat the underlying problem.”