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Factors affecting dentist participation in a state Medicaid program
P C Damiano1, E R Brown, J D Johnson
1Department of Preventive and Community Dentistry, University of Iowa, Iowa City 52242.
Journal of Dental Education
|November 1, 1990
Summary
Dentist participation in Medicaid (Medi-Cal) is declining due to low fees and administrative burdens. Addressing these issues is crucial to ensure continued access to dental care for Medicaid patients.
Area of Science:
- Health Services Research
- Dental Public Health
- Healthcare Policy
Background:
- Provider participation significantly impacts healthcare access for Medicaid recipients.
- A trend of providers limiting acceptance of Medicaid patients is evident.
- Common reasons for non-participation include low reimbursement, excessive paperwork, and administrative complexity.
Purpose of the Study:
- To investigate factors influencing dentists' decisions regarding participation in the California Medicaid (Medi-Cal) program.
- To identify key challenges faced by dentists within the Medi-Cal system.
Main Methods:
- Conducted telephone interviews with 92 dentists in California.
- Assessed factors influencing participation decisions in the Medi-Cal program.
Main Results:
- Low reimbursement fees, payment denials, and patient no-shows were identified as major program issues.
- Non-participating dentists cited concerns about no-shows and paperwork.
- Participating dentists expressed greater concern regarding the limited scope of covered services.
Conclusions:
- Both participating and non-participating dentists share similar concerns about the Medi-Cal program.
- Failure to address identified program issues may lead to further attrition of participating dentists.
- Ensuring continued dental care access for Medicaid beneficiaries requires program improvements.