Shortage of Massachusetts Dentists Willing To Provide Care After Dental Benefits Extended

Massachusetts faces challenges in providing access to dental care for low-income residents because only 17% of dentists in the state are willing to accept new patients who have state-subsidized dental coverage, the Boston Globe reports. As part of the state's health insurance law, dental benefits were restored to about 540,000 low-income adults who had lost nearly all dental coverage in 2002. The law also expanded eligibility in state-sponsored health plans, which allowed an additional 140,000 adults to enroll in Medicaid, called MassHealth in the state, or the newly created Commonwealth Care.

Since 2006, more than 200,000 adults covered at least in part by the state sought dental care. State data show that the number of Medicaid beneficiaries who saw a dentist more than doubled in the first year after the law took effect, from about 15% of adults to 35%. According to health advocates, thousands more are expected to seek care in the coming months as community health centers and other groups launch an education campaign about the need for preventive care for children and adults.

The percentage of dentists who accepted people enrolled in subsidized health plans increased from 10% to 17% in 2006 when the state allowed dentists to limit the number of low-income patients they treated. However, Catherine Hayes, a professor at Tufts University School of Dental Medicine, said that a fifth of that 17% has stopped accepting new beneficiaries. Karen Rafeld, Massachusetts Dental Society's associate director, said the dental society has had a difficult time encouraging more dentists to join because "it's still a bureaucratic nightmare."

Dentists say it is unfeasible for them to accept many low-income patients because the state reimbursement rate for treating adults is half of what private insurers typically pay. In addition, dentists criticize payment delays and the "burdensome paperwork" needed to join the program, the Globe reports. Rafeld said that until the state raises the rates and fixes the process, it will be difficult to recruit more dentists to the program.

Kerin O'Toole, spokesperson for Massachusetts League of Community Health Centers, said that without more dentists providing preventive care, "we risk treating people with more expensive and serious health issues" (Lazar, Boston Globe, 8/7).