thousand patients from a four county region travel the narrow rural roads to
Oceana, W.Va., population 1550, for dental care.
Morgan travels 80 miles roundtrip because dentists Michael Moore and his wife,
Michelle Brown, are willing to accept her Medicaid insurance.
a lot of them that won’t,” said Morgan. “Financially it’s hard to come up with
the money to pay a dentist, so it means a lot for someone to actually take the
There are approximately 800 dentists and 42 oral surgeons in West Virginia.
Moore and Brown are among
the very few who do not limit the number of Medicaid patients they’re willing
less and less dentists willing to accept Medicaid, it just raises the number of
patients we need to take care of,” said Moore.
“We’re reaching a point to where it
begins to put us in a financial bind because the reimbursement rates are so low.”
Moore is a native of Braxton County and Brown grew-up in Oceana.
wife and I are only two human beings and while we try to take care of everyone
that we can, if I say yes to everybody I’m going to have to put a cot right
here and just continually see people,” Moore said.
Moore estimates 75 percent
of their patients have Medicaid and says the program reimburses at less than
half of what he charges.
don’t want to call it a crisis but it’s pretty close to it,” said Richard
Stevens, West Virginia Dental Association Executive Director.
says Medicaid hasn’t approved an increase in reimbursement rates for dental
providers since 1991.
1994 the state Medicaid program reduced those fees by 30 percent.
last action on reimbursement fees came in 2001, when only a limited number of
preventive and diagnostic services saw a modest increase.
says it’s a frustrating situation: 50 percent of children in the state are on
Medicaid and dentists want to care for them.
year 600 dentists filed a claim with Medicaid. Now some may have only filed a
claim for a dozen or a half a dozen children,” said Stevens.
you can’t blame dentists for not treating children, because they are treating them,” he said. “But they
can’t be expected to overload their practices, being reimbursed at below their
cost of services.”
just not economically feasible. Here we’re looking at fees that are 20 years
old,” said Stevens.
Moore says raising the
reimbursement rates would increase access for patients and help recruit
dentists into underserved rural areas.
also says the scope of Medicaid coverage is inadequate, only covering
check-ups, x-rays and tooth extractions once a patient turns 21. Tooth-saving
procedures for adults are not covered.
can’t look at people and say ‘Well I think good health care is a privilege
reserved for only a certain group of people,’ because I don’t believe that,”
think health care is a basic human right, and that certainly includes dental
Congress struggles toward an agreement on health care restructuring, the
American Dental Association is lobbying for an expansion in Medicaid’s dental
coverage and provider reimbursements.
this stage of the Washington
debate, Stevens says dental coverage hasn’t received the attention it needs in
health care reform.
health care is kind of a sidelight,” said Stevens.
beyond my understanding why the oral cavity has been separated from the rest of
the body when it comes to health care.”
says the ADA is
also advocating for an increase in Public Health dentists and a loan
forgiveness program for dental graduates willing to serve in rural areas.