Four Corners short on dentists

Thousands of Medicaid patients expected in April; Southwest Memorial already treats emergency cases

Few dentists are available in the Four Corners area to see thousands of new Medicaid patients when benefits are extended in April.

The change is meant to help provide adults who receive Medicaid with dental care before they visit the emergency room.

In 2013, 82 Medicaid recipients visited the emergency room at Southwest Memorial Hospital for dental care, CEO Kent Helwig said.

“It’s really not a good use of community resources,” Helwig said.

Many of these patients visit the hospital for pain management, but doctors are unable to provide them with the more thorough and preventative dental care that they will be eligible to receive.

But dental deserts, regions where dental care is limited, are widespread across Colorado, according to a report by the Colorado Health Institute released last week. The Four Corners area is no exception.

In Dolores County, a federally qualified health center is the only place where a Medicaid dental patient can be seen. In Montezuma County, three of the nine private dentists serve Medicaid patients, the report said.

The problem is most severe in Colorado’s rural areas. Eight counties have no dentists, and in 17 counties there are no dentists who accept Medicaid.

The expansion is not part of the Affordable Care Act, also known as Obamacare. It was voted in by the state legislature earlier this year. The dental benefit is capped at $1,000 and only covers certain services. Previously, only children and teens were eligible to receive dental benefits through state Medicaid.

This year, the state also raised the income limits to enroll in Medicaid. Both changes will make 844,000 new people eligible by 2016, up from 348,142 in 2012, according to the report.

Montezuma County is set to see the number of eligible dental patients balloon from the about 2,400 in 2012 to 5,800 in 2013.

Many dentists choose not to serve Medicaid patients because of the cost of billing and low reimbursement, according to the report.

Health Services Division Director Vanessa Boyd, of San Juan Basin Health Department, said public health providers can’t afford upgrades to billing technology and therefore government reimbursement may only cover the cost of the billing.

“Public health hasn’t invested in billing infrastructure the way private clinics have to,” she said.

This year, Colorado increased the Medicaid reimbursements by 4.5 percent for private dentists and by 2 percent for federally qualified health centers.

But the report predicts that will be not be enough to attract dentists to Medicaid.

Boyd said Medicaid patients are more likely to miss appointments, and adult dental patients can be more time-consuming than children and less appealing to accept as patients.

The Colorado Dental Association is working with the state and private dentists to address the problem, said Quinn Dufurrena the association’s executive director and a dentist.

The association recently launched the Take Five program, which is aimed at recruiting private dentists to just take five families on Medicaid to help distribute the load.

The association is also working with the state to try to lighten paperwork for dental offices.

This problem is not specific to Colorado. In fact, Colorado ranks fairly high, No. 16, in the nation for total number of dentists, the report said.

“A lot of people in this country get their dental care by going to the emergency room when they are in pain,” he said.