Reimbursement Rate Cuts
The Governor proposed a rate reduction of 3% for all health care funding. The savings to the state would be $96 million. While we recognize that there is a significant state budget shortfall, we are resolute in our need for increased public program funding for dental patients.
Minnesota Dental Association’s position:
We firmly believe that the best way to improve dental access in rural areas is to INCREASE reimbursement rates as a further means of encouraging dentists to locate to these and other underserved areas.
- An essential element of improving access to dental services for underserved and handicapped populations is to encourage dental practices to treat a higher volume of Minnesota Health Care Program recipients. This can be accomplished in part by increasing the reimbursement rates for dental procedures to make them more reflective of current marketplace rates. Current payment rates for Medicaid and Minnesota Care are typically about 30% of actual costs, well below the cost of providing treatment and among the lowest in the nation.
- In a 22-county experiment in Michigan, the Medicaid program began reimbursing dentists at usual customary and reasonable (UCR) fees. The result was a 50 percent increase in the number of children receiving treatment in just the first four months of operation and a 40 percent increase in the number of participating dentists. Raise fee levels and an extraordinary number of people get treated.
- Until reimbursement rates for all dental procedures are raised to a minimal level that at least covers the cost of providing care, there will not be a significant increase in dentists enrolling in the program and improving access. The minimum level of reimbursement should be at least 64% of the median fee charged by dentists according to the most current regional ADA fee survey. In states where reimbursement has been raised near the medium fee, the number of participating dentists has increased, in some cases dramatically.
- Poor financing ultimately leads to patients’ inability to access oral health care services, which only intensifies the severity of their need for help. Improving financing and program administration will improve access for Medicaid beneficiaries who need assistance.
- If funds are not available legislatively to accomplish this for all public program patients, increased reimbursement rates for services provided to children should be sought.
Despite the fact that dentists serving public patients receive only about 35% of the actual costs for treatments, the Governor proposed across the board rate cuts of 3% for ALL health care providers. In addition, the House and Senate actually increased the rate cut to 5%! We were able to ensure, however, that this applied to physician reimbursement under their section of the law, and NOT to the dental codes and our section of the law. Thereby, we avoided a 5% cut in dental state program rates.