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Editorial: The real pain of bad Medicaid dental policy

 
Published May 6, 2016

It comes as no surprise that Floridians are showing up at hospital emergency rooms with big dental problems costing taxpayers millions of dollars. They don't have anywhere else to go, often because few dentists accept Medicaid patients because the reimbursement rates are so low. For this penny-wise, pound-foolish policy, blame the miserly Florida Legislature.

A new study by the Journal of Public Health Dentistry found dental-related visits to hospital emergency rooms soared by nearly 57 percent between 2005 and 2014. The total charges rose to nearly $194 million, with about half of the cost paid by Medicaid or Medicare — taxpayers. As one of the study's authors told Tampa Bay Times staff writer Kathleen McGrory, emergency rooms are "about the least appropriate, most expensive place you can go for dental care.'' Those emergency rooms are not generally equipped to deal with the real dental problem and often just provide painkillers and antibiotics to the suffering patient.

Many of those issues could be prevented or reduced with routine dental care and getting tooth fillings or root canals when needed. But many adults on Medicaid don't get that treatment, in part because only about 8 percent of the state's dentists accept Medicaid as payment. And Medicaid plans in Florida only have to cover emergency dental services, although in the last two years the plans started offering limited services such as oral exams and X-rays.

This health care strategy makes no sense for patients or taxpayers. The prescription is obvious: regular dental care, more generous Medicaid policies, higher Medicaid reimbursement rates and more dentists who accept Medicaid. Why should taxpayers spend more in hospital emergency rooms on dental issues when investing in better care on the front end would save money?