Dental care demand explodes across the state
Medicaid struggles to find additional providers to meet increasing need
The dental clinic buzzed with activity Friday afternoon.
The Augusta Regional Dental Clinic in Fishersville, like many others that serve Medicaid customers across Virginia, has been very busy for months — especially as more and more have learned about the expanded benefits for adults, according to Sophie Parson, director of the clinic.
The need for services is so great, people have called the clinic trying to get an appointment from Louisa County, roughly 60 miles away.
On July 1, Medicaid began covering more dental procedures as a result of Virginia’s decision to expand Medicaid eligibility during former Gov. Ralph Northam’s administration.
“But there is nobody to deliver,” Parson said.
The number of dental providers that accept Medicaid patients has fallen to 1,888 from a peak of 2,031 in 2017, according to data provided by Virginia Department of Medical Assistance Services.
“It’s getting to the point where people are refusing to use benefits to be seen faster,” Parson said.
The procedures are often not just cleaning or minor maintenance, but serious health issues such as an infected tooth.
“They need a lot of work done and they need it now,” Parson said.
Staff of other dental clinics across the commonwealth, such as in Suffolk, also said they are struggling to meet the demand for services.
DMAS is seeking to bring more providers into the fold to shorten the wait lists and connect Virginians with the new services, according to Karen Kimsey, director.
She said the department is “excited” about providing the new treatments and procedures, especially in cases in which Virginians may have never been able to get dental care at all.
“Oral care is health care,” Kimsey said.
The services are now accessible to over 136,000 Virginia Medicaid members, according to Kimsey.
“In the past, we did have some services for adults, but it was predominantly for children and pregnant women,” she said.
A major component of the expansion was to cover more than extractions for Medicaid patients with teeth that are in a bad way,
according to Kimsey. Since July 1, there have been nearly 170,000 restorative treatments to Medicaid members’ teeth, including filings and crowns, she said.
Facilities such as Western Tidewater Free Clinic in Suffolk set in motion plans to expand services, but those don’t materialize overnight, according to Ashley Greene, director of the development,
“There is a gap between need and availability, is what I’d say for sure,” Greene said.
Western Tidewater is doubling its dental chairs, from two to four, she said.
“We hope to be up and running and operational by spring and summer 2023,” Greene said. “It can’t come soon enough.”
In and around Goochland, west of Richmond, clinic GoochlandCares started the process to become a Medicaid dental provider last year after realizing the shortfall in care that would happen in the area, according to an email from Adina Keys, clinic director.
“We learned last summer that about 1,300 Goochland residents would be eligible for Medicaid in our county,” she said. “A survey of the few dentists in our area showed that none would be accepting new Medicaid patients.”
In Richmond, staff of Virginia’s only dental school have said it is also having trouble meeting the new demand.
“Additionally, current reimbursement rates that have not increased in approximately 15 years sometimes fail to meet the actual cost of delivering care,” said dentist Lyndon Cooper, dean of the VCU School of Dentistry. “This challenges us and all other oral health care providers to operate in a fiscally responsible manner.”
Over the past nine months, there has been a 67% increase in the number of Medicaid patients over the age of 21 going to VCU Dental Care, compared with the same timeframe last year before the expansion, said Donnie Parris, director of patient business services and financial analyst at VCU Dental Care.
“We have also witnessed increased demand for restorative and prosthodontic treatments as more patients gained access to important comprehensive dental coverage,” he said.
That has also presented an opportunity for students of the institution to train in more specialty areas such as endodontics and prosthodontics, said dentist Richard Archer, senior associate dean of clinical education at VCU School of Dentistry, in a statement.
“It has also opened our students’ eyes to the need that exists in our communities and the impact that oral health care has in the lives of those who never had access — as well as the realities of billing and the different reimbursement rates provided by insurers,” Archer said. “We are committed to finding solutions that build on the progress that has been made, including bringing more providers into the equation to meet the oral health needs of our communities.”
On Feb. 12, Augusta Regional Dental Clinic started a waitlist and as of last week, there were over 200 people on it, according to Parson. And though they, like the other clinics, will prioritize patients based on need, it still means those with a serious issue could be waiting weeks, if not months, to be seen.
“Its very sad and frustrating for us and the patients,” Parson said. “It’s a very difficult situation.”
Staff at the clinic are already working 10-hour shifts and the situation has left Parson at wit’s end.
“What else can we do?” she said. “It’s really tragic. There’s no other word.”