Dentists Not Impressed with Medicaid

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In this survey, we asked dentists if they accept Medicaid.

Two-thirds of dentist respondents revealed that they do not accept Medicaid payments.

Though one in three dentists does take Medicaid, many were unimpressed.

General dentists are three times as likely to accept Medicaid as are specialists.

Specialists often offer more expensive procedures, some of which are for purely cosmetic purposes. So it's not surprising that specialists are less likely to rely on Medicaid.

Rural dentists are in a very different boat. The majority of them do accept Medicaid, whereas most of their urban and suburban colleagues do not.

Why bother?

"Too much red tape, broken appointments and unappreciative patients. Not worth my time or my staff's time." (Alaska dentist)

Inadequate reimbursement

"Medicaid is a loss leader. If they ever reimburse for what the procedures/time/materials are worth, I might change my mind." (Arkansas dentist)
"Medicaid rates are so low, they don't even cover overhead." (Florida dentist)
"The government should raise the reimbursements sp they are at least in line with insurance company levels." (Nebraska dentist)

Medicaid could shut you down

"Any dentist would have to be NUTS to accept Medicaid. If you are even suspected of impropriety, say by a disgruntled employee, the Feds can SHUT YOU DOWN. Yes, on suspicion only! They can freeze your assets and shut your practice down. It could be years before you get due process. The risks are truly tremendous. And it's for a pittance, for pennies on the dollar. I know of one dentist who is in JAIL and lost his license over $8000 in clerical errors over a period of five years! I wouldn't accept Medicaid (sign my life and constitutional rights away to the Feds) if they offered DOUBLE my fees." (Florida dentist)
"I will not work for the government due to their unreasonable methods of dealing with errors or other problems." (Tennessee dentist)
"With all the dentists being prosecuted and some thrown in jail lately for what appear to be honest coding miscoding mistakes, I'd quit dentistry before I'd take Medicaid patients. It's just too risky." (Texas dentist)

It's about giving back

"I don't treat these patients for the money. I treat them because they are children who need orthodontic care that may influence the rest of their lives. A healthy smile may open the world to them! That's what we went into this profession for." (Rhode Island orthodontist)
"I can't in good conscience refuse to treat a patient because of who pays the bill, especially if an existing patient falls on hard times." (New York dentist)
"I lose money on each Medicaid patient I see, but it's a matter of charitable community service. If dental services are not furnished by the licensed dentists of a state, then where do these poor people obtain necessary dental treatment? Nobody else has the skill or education to do it." (California dentist)

Medicaid patients are unreliable

"I accepted Medicaid for 18 years, but no longer serve this population. They are the most unreliable and ungrateful group of patients, not to mention the low reimbursement of fees." (Kansas dentist)
"Treatment is not adequately reimbursed, and unfortunately the patient often no-show. That creates a sour environment for the next person calling in for care. I'm stymied." (Hawaii dentist)
"Patients don't show up because 'it's free.'"
"I notice that those who get free care are the most likely patients to fail to show up to receive it, and the most likely to make complaints and pester for unnecessary narcotics!" (Indiana dentist)
"These patients are very demanding, always threating to call DentiCal and complain and sometimes even get refunds." (California prosthodontist)

Patients need care

"It is an ethical and moral obligation to see these people. It is embarrassing that more of our colleagues do not treat some portion of this population in need." (Minnesota pediatric dentist)
"The cost of doing business increases, but the Medicaid reimbursement remains unchanged. Additionally, there are few specialists who are Medicaid providers, so many of our patients do not get the specialty care they need." (North Carolina orthodontist)

Children need care

"These kids need help. It is not always about the money." (Texas pediatric dentist)
"I think we have a certain responsibility to help the disadvantaged, especially children. If all dentists accepted Medicaid and treated a few every week, their bottom line would not be affected much." (Missouri dentist)

The system doesn't work right

"Medicaid is a broken system with erroneous measurable goals that do not necessarily measure the effectiveness. It's also grossly underfunded." (Colorado dentist)
"States promise but do not deliver adequate funding for socially-needed projects. Waste and mismanagement undercut the truly necessary oral health initiatives." (Connecticut dentist)

Not everyone has a choice

"I have to because the practice I work for accepts it." (Utah dentist)
"With the economy sliding downward, rapidly, I'm glad I've got the extra source in a small town." (Arkansas dentist)

The problem is that it's an HMO

"I used to accept Medicaid when it was based on a fee-for-service model of payment and there was a fee schedule that was previously agreed to by me and the insurance company. The fees were low, but I wanted to provide this service for the community--i.e., the sick, mentally challenged or financially challenged patients who made up most of my patient base. Then my state changed the way the reimbursement occurred to an HMO-type insurance. I abhor HMO care on the part of the patient and the dentist. I don't feel either one of us are getting the appropriate care--the insurance co. is the only one that wins with HMOs. I no longer accept Medicaid because of its HMO system." (Florida dentist)

Note: Survey sample included 117 respondents.