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Action for Dental Health

Private Practice Dentists Improve Oral Health Capacities of Community Health Centers in Montana

March 26, 2014

Longtime contracting agreements between community health centers in rural Montana and area dentists ensure the local residents receive both necessary and consistent dental care – regardless of their economic status. And such arrangements have the added benefit of allowing health centers to add or increase the amount of dental care they provide to patients without having to build dental clinics or hire dentists.

Sweet Medical Center, a Federally Qualified Health Center in Chinook, Mt., serves about 1,900 patients per year, according to Meghan Morris, the community health center's chief executive officer. Last year, the center referred 107 of those patients to four private dentists who contract with the health care center.

"We don't have a dental facility within our health center, but we have a building that we share with a local dentist," she said. "We send a lot of patients there."

Federally Qualified Health Centers receive grant funding from the federal Health Resources and Services and Administration and qualify for enhanced reimbursements from Medicare and Medicaid. FHQCs are required to provide comprehensive care for underserved populations, have ongoing quality assurance programs, and operate on a sliding fee schedule.

Patients who are at or below 200 percent of the federal poverty level are eligible for sliding scale fee discounts for health care services.

Sweet Medical Center caps its services at $250 per patient per year, according to Ms. Morris.

"We have funds that we allocate to dental vouchers," she said. "We budget a certain amount every year and offer as many services as we can until we hit the threshold."

The medical center started contracting with dentists more than 10 years ago, developing several long-term agreements. Although it has contracts on file with as many as 20 dentists, most of the referrals go to four.

"Particularly in rural areas, I have found that if you're committed to working in this type of community, then you're committed to serving the entire community," Ms. Morris said.

Dr. George Johnston said he couldn't agree more.

Dr. Johnston contracted with Butte Community Health Center's satellite office in Dillon, Mt., for several years before becoming an employee of that health center in 2009.

Butte Community Health Center scheduled patients for Dr. Johnston and another contracted dentist once a week. The two dentists provided services in their own offices and were paid a per diem by the health center.

"We had patients – and still do – who couldn't afford dentistry," said Dr. Johnston. "When I was contracting with the health center, there was a satisfaction in knowing that the patients were getting served, and that I didn't have to be concerned about overhead expenses."