Dentists That Accept Medicaid In Des Moines Iowa – Vadim, a 26-year-old truck driver from California, was on his way to New York when he began to feel pain in the left side of his mouth. He went to a dentist in Oklahoma, who diagnosed a tooth infection and prescribed antibiotics.
The pain subsided temporarily, but then intensified. After delivering the cargo to New York, Vadim felt too weak to drive alone, so his brother joined him. When they got to Utah, they had to take him to the hospital and put him on oxygen.
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Although deaths from dental infections are relatively rare these days, many chronic diseases can be directly attributed to poor dental health, especially in rural communities. In fact, rural Americans are twice as likely to lose their adult teeth as their urban counterparts. For these residents, tooth decay and periodontal disease are common, although largely preventable.
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What Makes Rural America So Vulnerable to Dental Disease? A number of factors come into play, creating an intricate web of inequality. Here are the top reasons:
Because dentists often graduate with heavy debt, they tend to set up practices in populated areas where they can attract higher-paying patients. Rural areas offer too few paying clients to make practices profitable.
Also, in high poverty areas (such as many rural areas), most potential patients are covered only by Medicaid, resulting in lower profit margins for dentists. (See “Fewer Dentists Accepting Medicaid” below).
With such a severe lack of dental services, rural residents have to travel long distances to receive oral care. This represents a significant burden for people without adequate transportation.
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Dental Medicaid rates in Iowa have not changed in 20 years, reimbursing only 30-40 cents for every dollar of care provided. As a result, fewer dentists in Iowa now accept Medicaid.
A dental HPSA (Health Professional Shortage Area) is a federally designated area or population with an acute shortage of dentists.
And when each adult is enrolled in a Medicaid member state’s dental health plan, the annual benefit is limited to a maximum of $1,000 per year (excluding preventive, diagnostic, or emergency services).
Poverty rates are higher in non-metropolitan areas. Rural residents living in poverty cannot afford dental care or dental insurance. Even for working residents, research suggests that employers in rural areas are less likely to offer dental insurance than those in more populated areas. (See “Fewer Dentists Accepting Medicaid” above).
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Rural America is made up of people 65 and older. Most of these residents are unemployed and less likely to have dental insurance. Because they are older and sicker than urban residents, rural Iowans rely more on Medicaid and Medicare. Traditional Medicare does not include dental benefits, and of course, fewer dentists now accept Medicaid.
Disparities in dental care between urban and rural populations are not new, although they are becoming more pronounced as the US population ages. Over the years, numerous strategies have been proposed to address the gap in dental care.
Actively recruiting new dentists to fill gaps in underserved communities is critical in light of the current shortage and the impending retirement of many dentists.
Efforts like Project FIND (Filling Iowa’s Need for Dentists) do just that. Working with the University of Iowa College of Dentistry and the Iowa Department of Public Health, as well as professional and civic organizations, The Find Project has helped pay off loans and establish private practices for 56 Iowa dentists over the past 20 years
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The Iowa Area Development Group (IADG) is also actively involved in helping to obtain local financing and low interest rates to establish dental practices in rural communities.
A dental therapist is a mid-level provider who helps a dentist in the same way a nurse helps a doctor: by performing low-level routine procedures, allowing the dentist to focus on more complex cases.
Dental therapists are a new trend in health care that can increase access to underserved populations and lower dental costs. They are trained in routine preventive and basic restorative services, and are licensed to practice under the “general supervision” of a dentist.
This means they can travel and treat underserved populations across the state, even if there is no dentist.
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The I-Smile™ program, sponsored by the Iowa Department of Public Health (IDPH), is a statewide initiative to connect Iowans with dental, medical and community resources in all 99 counties.
The 23 designated program coordinators work with local dentists to establish dentists for Iowa’s underserved population and also work with community leaders to recruit new dentists.
A 2018 federal study recommended that individual states “evaluate emerging health professions, such as dental therapy, and consider how their licensure and scope of practice can increase access and reduce costs for consumers while ensuring safe and effective care.”
As of October 2021, 13 states have approved the use of dental therapists; Iowa is not one of them. (For a more in-depth look at how dentistry can benefit Iowa, see the white paper “Iowa Needs Dental Therapists”).
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Fewer dentists in Iowa accept Medicaid because the plan’s reimbursement rates are so terrible that they don’t even cover the cost of basic procedures. Neighboring states Minnesota and Wisconsin have had the same problem, recently increasing their dental reimbursement rates by 98% so that underserved populations can get the care they need.
Most dental practices in Iowa are small businesses that operate on a fairly tight budget. They love to give back to the community and often do so through various charitable programs. But they are forced to limit or exclude new Medicaid patients because they can’t do it any other way.
Increasing state reimbursement rates will allow more dentists to provide preventive care to rural Iowans, reducing the number of dental emergencies and the distance patients must travel to receive care.
Portable dental offices, like mobile dental vans, travel to various rural centers to provide preventive care, x-rays and other dental procedures.
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The following video clip highlights a mobile program led by Delta Dental to expand access to dental care for children throughout rural South Dakota:
Sources: Featured Image: Adobe, License Approved Health Journalism Us Iowa Rural Health Information Hub Tax Education Iowa Foundation Des Moines Register
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Many States Are Expanding Their Medicaid Programs To Provide Dental Care To Their Poorest Residents
© 2024 The content of this website is owned by us and our licensors. Do not copy any content (including images) without our consent. Many counties in Iowa are facing a shortage of dentists accepting new patients with Medicaid coverage. Due to falling rates of return…
Many counties in Iowa are facing a shortage of dentists accepting new patients with Medicaid coverage.
Falling reimbursement rates are dissuading providers from accepting Medicaid not only from new patients, but also from current and former patients.
Data from the American Dental Association shows that in 2016, dentists in Iowa earned 40 cents on the dollar providing services to a Medicaid patient. Combined with the 60% overhead, many dentists are losing money seeing a patient with government insurance.
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Now many are retiring. This means that many people on fixed incomes have to pay expensive trips to find someone who can brush their teeth.
Ph.D. Corey Garner, DDS, owns and operates Southside Smiles in Des Moines. It also accepts private insurance, government insurance and the uninsured.
She says patients come from as far away as Des Moines and as far as Marshalltown or even Sioux City to see her. It’s a six-hour round trip.
“We routinely have patients who travel two hours to come to our office, and those patients can’t find providers in their area that accept state insurance,” Garner said.
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With historically low return rates, Dr. Many providers are unwilling, or even unable, to serve low-income people, a population that often faces other challenges, Garner said.
“Some patients do not speak English and interpreters are often needed. There is also a wide range of people dealing with mental health issues or past and current drug and alcohol use,” Garner said.
I-Smile data from the Iowa Department of Public Health shows that in 2018, about 47 percent of dentists provided dental services to a child 12 years of age or younger with Medicaid coverage. a
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