Strengthening and expanding the Dental Safety Net and promoting effective solutions to fund care
Despite the fact that oral health has a direct impact on overall health, dentistry is quite different from medicine in the way that it is funded. The vast majority of dollars spent on dental care still come from individuals, families and their employers through benefits plans.
One in three New Mexico residents receive their only health care through Medicaid, but unfortunately, dental coverage for adults and seniors through Medicaid falls short of providing the amount and extent of dental care needed.
Action Plan Initiatives:
1. Reform and expand Medicaid to streamline claim submission, provide improved benefits for adults and seniors and reimburse at reasonable market-justified rates. In 2014, the New Mexico Dental Association created a Medicaid Advisory Workgroup with state Medicaid leadership to work together towards accessing the untapped capacity New Mexico dentists have to serve low-income patients by eliminating burdensome red tape and exploring alternative compensation models to encourage increased participation.
2. Establish a dental benefits “bill of rights” to assure that patients may see the dentist they choose without inappropriate coercion or penalties. Some states have enacted legislation that insures that patients have the right to select the dentist of their choice. Even if New Mexico did, plan providers circumvent these protections through coercive plan provisions. New Mexico would benefit from a patient’s bill-of-rights that “levels the playing field” for all involved. Provisions might insure that patients may choose a dentist that is close by or provides the services they need and value, without being penalized or coerced. By “leveling the playing field” normal competitiveness and market pressures would contain costs and improve care.
3. Remove gross receipts tax from all non-elective health care services. Although the public believes that health care was exempted from gross receipts tax a few years ago, it remains as a major factor in the cost of care in New Mexico. It is a largely hidden cost of doing business as a dentist in the state and a disincentive to those considering practice here. Practitioners may be discouraged from locating here, particularly in rural areas, because comparable locations in adjacent states are not taxed. They simply cannot afford to compete with practices within easy driving distance, whose cost of business starts out 7% less than their own. Any serious plan to address unmet health needs should include a phase out of gross receipt taxes on health care services.
National initiatives supported by the New Mexico Dental Association
• Help provide more care to people by having private-practice dentists contract with Federally Qualified Health Centers. By partnering or contracting with community health centers (PDF), private dentists are able to help these safety net facilities expand their capacity to provide care to underserved populations (primarily children on Medicaid), without increasing the clinics' "bricks and mortar" expenses and staffing overhead. Patients benefit because quality care can be quickly and efficiently delivered, alleviating much of the backlog experienced by many health center dental programs. Access to dental specialty services can also be increased. Contracting with the health centers allows private dentists to work with underserved populations without having to contend with many of the administrative headaches of the Medicaid program.
ADA Letter in Support of Reauthorizing Funding for Community Health Centers
Bipartisan Senate Letter in Support of Reauthorizing Funding for Community Health Centers