Missouri is experiencing a renaissance in attention to oral health policy.
Champions in the state legislature are working to ensure oral health policy is a relevant topic through legislation and through the oral health caucus. The Coalition’s annual oral health policy conference brings fresh innovation to the dialog inside and outside of the statewide network of oral health advocates. Early this spring dental coverage for adults eligible for Medicaid will return after a 10-year plus hiatus. That is great news for Missouri. We can look forward to people accessing a system of care instead of showing up at emergency rooms because of untreated dental conditions.
But challenges remain.
Missouri has one of the lowest participation rates of dental professionals in Medicaid of any state. There are likely many factors that play into this, but provider rates are a key factor. The simple fact is that the costs of providing dental care far surpass Medicaid dental rates. And that has remained constant for many years. The Missouri House and Senate recognized this fact when they passed the the state fiscal year (SFY) 2015 budget (July 2014 through June 2015). The legislature looked ahead to see a time when Medicaid beneficiaries could access oral health care regularly in all areas of the state by including a significant dental provider rate increase in the SFY 2015 budget.
Unfortunately, Missouri Governor Jay Nixon withheld funds for SFY 2015 out of concerns for adequate state revenues. When the budget for SFY 2016 (July 2015 through June 2016) was constructed, significant dental provider rates were not included. This should be corrected. As it stands, the number of dental providers who take Medicaid will likely not meet the demand for care, particularly in many of the rural areas of Missouri. Without system capacity to meet the need, it will be a slow process to reap the financial and health benefits of routine care.
Paying providers a reasonable reimbursement for their professional services does something quite simple: it makes it feasible for providers to take on the complexity of providing care for Missourians who have had little to no dental care for many years, and who – unlike many middle class people with stable jobs and income – are unaccustomed to regularly getting needed preventive and treatment services.
To address the needs of Medicaid-eligible Missourians, providers have to address longer-standing dental issues while learning to adapt their practice to work with this unique population. In states where dental rates have gone up, dental provider participation in Medicaid has increased.
The Missouri legislature has shown significant insight in reinstating adult dental coverage to Missouri Medicaid. We are grateful. If we are to see the full financial and health benefits of regular access to dental care come to fruition, we need to get back to the foresight of the SFY 2015 budget.