Monday, February 23, 2015

New study: not enough dentists to care for Colorado's Medicaid enrollees

Colorado does not have enough dentists to adequately care for all of the 1.1 million Medicaid clients who now have dental coverage, according to a new Colorado Health Institute study.

Two policy decisions have resulted in a historic number of Medicaid clients with dental benefits. First, Colorado expanded Medicaid eligibility to more low-income residents. Colorado also extended dental benefits to all enrollees, even the adults who were not previously covered for dental care. This places Colorado among the nation’s leaders when it comes to oral health coverage for those with the lowest incomes. It also presents a significant challenge: ensuring that these new enrollees, many with longstanding oral health issues, can find care in a state already struggling to field an adequate oral health workforce to serve lower-income Coloradans.

The research brief, “Filling the Dental Gap: Can Colorado Meet the Growing Need?” finds a widening gap between the demand for oral health care by Medicaid enrollees and the supply of oral health providers.“Colorado has taken important steps to improve oral health,” said Sara Schmitt, Director of Community Health Policy, who teamed with Senior Analyst Rebecca Alderfer and Research Analyst Hannah Wear to conduct the study. “Now the challenge is ensuring that the Medicaid enrollees who need care are able to get it. Important work is underway, but the need is great.”  

The number of Medicaid clients with dental benefits in Colorado has tripled in little more than two years. The number of registered dentists and other professionals has climbed as well, but not nearly as fast. The situation is especially tough for Medicaid enrollees in 15 Colorado counties. Eight of them are dental deserts — areas that do not have any dental care at all. The other seven counties have some dental care available, but they do not have a dentist in private practice who accepts Medicaid or a safety net clinic offering dental services.

The new report also offers a county-by-county analysis of the dentist workforce, allowing for comparisons. Statewide, there are 1,262 Medicaid enrollees for each Medicaid dentist, according to the CHI analysis. But there is wide variation among counties. For example, Las Animas County has a ratio of 4,778 Medicaid enrollees for each Medicaid dentist while Adams County has a ratio of 753 Medicaid enrollees for each Medicaid dentist. The report also highlights a number of programs underway across Colorado to begin addressing the dental care gap.

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