Minnesota Dentists Mobilize to Push for Higher Medicaid Rates

Dentists in Minnesota are hoping to enlist the help of patients in an effort to sway state lawmakers to boost Medicaid reimbursement rates.

The Minnesota Dental Association has kicked off a public awareness campaign aimed at convincing lawmakers to allocate more money toward the state’s Medicaid dental program. The campaign highlights the wide divergence between Medicaid payment rates from state to state. Minnesota currently ranks next to last in reimbursement rates for pediatric dental care. Carmelo Cinqueonce, MBA, executive director of the Minnesota Dental Association, said the issue is not new.

“This is a concern we’ve had for several years,” he told Dentist’s Money Digest^®.

Cinqueonce said the issue came to a head when the American Dental Association’s Health Policy Institute (HPI) released a report showing Minnesota had the lowest reimbursement of any state for pediatric dental care.

A campaign subsequently helped get additional money, but not enough to keep up with other states. As of HPI’s most recent report, Minnesota Medicaid reimbursement equaled just 31.1% of the fees charged by dentists. Only Michigan, at 30.7%, had a lower reimbursement rate.

“The legislature, they do throw in a little bit of money here and there, and we’re very grateful for that,” Cinqueonce said. “But we need more in order to really turn the tide and address the problem that’s lingering for so long.”

The MDA estimates the state would need to invest between $50 million and $60 million per year in the state’s next biennial budget in order to close the funding gap.

Reimbursement rates vary dramatically from state to state. According to the HPI report, Delaware has the highest reimbursement rate for pediatric dental services, at 82.3%. Among states that use a managed-care model, like Minnesota, the highest reimbursement rate is found in Kentucky, which has a 77.9% reimbursement rate.

More than half of states are somewhere in the middle, between 40% and 65%. Only 8 states have a reimbursement rate of less than 35%.

While the lack of funding is a financial issue for dentists, it’s also a major access issue for patients. Low reimbursement rates have caused some dentists to stop participating in the Medicaid program, and others have capped the number of Medicaid patients they’ll take.

That can make it increasingly difficult for patients to find a dental practice willing to take them on.

The problem in Minnesota is receiving scrutiny from the Centers for Medicare and Medicaid Services.

“A year and a half ago the state was put on notice that they needed to do something to address access to care,” Cinqueonce noted.

The April 2017 letter from CMS noted that, in 2015, only 41% of Medicaid patients in Minnesota between the ages of 1 and 20 received any dental service, compared with the national average of 50%. The letter also pointed to an HPI study finding that, in 2014, 71% of commercially insured children in Minnesota received a dental service, while just 42% of Medicaid children did.

Cinqueonce said many dentists want to see Medicaid patients, but the state’s reimbursement levels make it difficult.

“Unfortunately, the economics of it drive many members and many dentists to make that hard decision of saying I can’t contract with Medicaid, I can’t see these patients because reimbursement is so low,” he said.

Conversely, the HPI report found states that increased reimbursement rates had an increase in dentist participation.

The Minnesota State Legislature is not in session at the moment, so any action won’t happen for months. However, Cinqueonce said the group is launching its campaign now in order to drum up momentum. In addition to a public relations and lobbying push, the organization has also launched a petition drive to give the general public a chance to voice their concern. Cinqueonce said he believes Minnesotans will want to remedy the problem even if they personally are not on Medicaid.

“As a citizen of Minnesota I think we owe it to ourselves to not be at the bottom of the pack,” he said.