More comments have poured in as a result of our last article containing remarks from dentists about the state of their Medicaid practices.
Medicaid dentists are having difficulty grappling with the crushing weight of rising costs and woefully inadequate Medicaid reimbursements, leaving many to question the viability of their practices.
Below, we share more of these powerful statements, reflecting the urgent crisis facing Medicaid dental professionals across the state.
More and more providers are going to close shop and go work in areas for more money and less hours AND avoid the ethically questionable bureaucracy of Medicaid. It breaks my heart as a Medicaid provider because the bottom line is less children will get the treatment they greatly need. – M.M.
As a dentist in Texas, TDMR’s article on Medicaid dental practice challenges hits home. Rising costs and stagnant reimbursements make it hard to keep my practice running. Staff retention is a constant struggle. Without higher Medicaid fees, many kids could lose access to dental care. Texas Health and Human Services must act quickly to raise rates and support our practices. – Dr. F.
We have Medicaid patients , that come into our office on a weekly basis, that have untreated permanent molars that now require endo or even extractions. I keep hearing the same story: Dentists refuse to treat them by scheduling them months in advance and then cancelling their appointments. However, it’s clear that the actual reason is due to low reimbursements and so the dentists just pass around their patients like their freakin hockey pucks. Something needs to change! This is unacceptable!! Especially for such a “great” state like Texas! Simply embarrassing and atrocious!! – C.J.
At some point, this goes back to the original lawsuit before they raised fees in 2007 called “BARRIER TO CARE”. !!! In addition, we all lose money to their ever changing rules on what is paid and what is not paid. If you don’t pay attention, you don’t get paid unless you cross all your T’s and dot all your I’s . When dental home was first introduced I lost over $40,000 of legitimate billable fees to Medicaid For legitimate approved hospital cases. And it was all because the client did not choose us as dental home. WHAT USE TO REQUIRE ONE EMPLOYEE, NOW REQUIRES THREE EMPLOYEES TO PROCESS THE OVERWHELMING PAPERWORK TO BE REIMBURSED !!! We are always running a race with lots of hurdles. The problem is the hurdles are being constantly moved and, if you don’t pay attention, you don’t get paid Pediatric Dentists are suffering. I have been doing Medicaid for 40 years. I felt that God gave a gift of serving children, all children, especially underprivileged children. I have personally talked to Governor Abbott twice. He said, and I quote, “ That Medicaid has not raised their fees since the iPhone was invented”. In fact, we got decreased 2 to 3% a couple of years later. He promised, that the state of Texas had $20 billion over and above what Texas needed to run the state. Of course, this was in an election year and we got put on the back burner, while property owners received tax relief Instead. We need reasonable fees for reasonable services. Medicaid needs to simplify all the rules and requirements across all insurances. and finally, I agree that there should be some sort of automatic increases to fees, according to inflation. At this rate, so many of us can’t pay our bills or give our employees raises because inflation has eaten at their checks accordingly. Hopefully, We can all show up in November at the public hearing and testify. – Dr. C.B.
The article and comments illustrate the struggle many of us dentists feel at this point in time. It is hard to be operational with the rising costs of operating a business such as dental where costs have skyrocketed, and hard to retain staff with the competitive labor market and necessity to have staff dedicated to provide excellent care- while dealing with all the paperwork like Dr. Culberson mentioned. I enjoy seeing patients who have Medicaid because a lot of the patients need the care and education, plus there are not many providers who will see them due to the poor reimbursements, and others kick the can down the road like Dr. Chris mentioned above- but I do lose sleep at night wondering if it is worth it or if I should just close up shop when my lease renewal comes in a year and I can’t help but wonder how many others are thinking the same. It’s hard in this environment with such low reimbursement. I have been practicing for 10 years and have only seen a 3% drop, and had no idea that fees have not increased since 2007. The article was eye-opening for me and I hope the state realizes the necessity to increase fees or else there will be a shortage of providers leading to poor access to care. – Dr. A
There are concrete limits to what can be accomplished for the underserved children in Texas due to rising costs of staffing and materials. Inflation may have slowed for now but it is still increasing significantly year over year. Without annual or semiannual fee increases or adjustments, it’s hard to imagine a scenario that doesn’t result in inflation and staffing costs resulting in shuttering of dental offices. Once closed, it is unlikely that they will return with any haste unless major improvements to Medicaid happen. The underserved will become the unserved. – Dr. H
What more can be said?