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Big Changes for New York Medicaid Dental Services
This summer, New York’s Medicaid dental services were switched into managed care, the effects of which have not yet been completely determined, according to an Albany Times Union article. While the state Medicaid director believes that this will help to provide patients with dental access, there has been some controversy as to the effect this will have on the efficiency of dental practices. Managed care, a fairly recent development in healthcare, has recently been debated heatedly in both medical and dental planning. In effect, managed care programs involve insurance companies taking a more aggressive role with the healthcare provider in terms of controlling what they will and won’t pay for, keeping the focus on preventative services.
The Managed Care Dental Debate
According to the New York State Medicaid Director Jason A. Helgerson, “The whole point of managed care is that we are paying an entity to actively work with patients and providers to make sure that people are getting the appropriate care. A lot of that focus is to redirect spending from higher-cost services — after something bad has happened — to move those expenditures upstream into preventive care.” It is the belief of the Medicaid supervisor that this will allow more of the Medicaid patients access to dentists. “We think at the end of the day, managed care leads to better access to vital services, in particular preventive services like dental care. We didn’t do this change to save money, but to improve access to dental care.”
Yet dealing with managed care companies has been notoriously difficult for dentists. The executive director of the New York State Dental Association, Mark J. Feldman, says that complicated processes, paperwork and poor reimbursement rates have made dentists wary of joining these groups, due to the decreased efficiency that often follows.”The dentists throw up their hands in frustration and say it’s not worth it anymore.” Another association official stated that the managed care industry’s interests do not necessarily align with those of the patients: “The company’s profitability is linked to how much care it provides. The less care they provide, the less doctors in their network, the more profitable the program is.”
How Will This Affect Patients in New York?
As most downstate patients who would be affected by this change are already enrolled in managed care plans, this change mostly affects those living in upstate New York. Yet for those who are affected, there could be a major increase in the percentage of eligible patients visiting a dentist, which means lower rates of long-term dental conditions. The statistics from 2009 show 29% of adults and 40% of children on regular Medicaid visiting a dentist. For those on managed care Medicaid plans, that number was 40% for adults and 51% for children, a dramatic increase. Children on private insurance plans do not visit the dentist more consistently, at only about 58% overall.
For those living in Ardsley, Hartsdale, Scarsdale, Greenburgh and the surrounding areas who are on Medicaid, managed care may mean an increase in their ability or incentive to get regular services and checkups, including teeth cleanings, fillings, and other preventative work. More serious procedures such as root canals and tooth replacement may be provided only when needed, and may not be as straightforward as preventative measures. Patients interested in porcelain veneers, dental implants, teeth whitening and other cosmetic dentistry will not be affected by these actions, as these services are not generally covered by insurance.