Kansas Medicaid program still lags nation in oral health care for kids

The Kansas Medicaid program seems to be catching up with the rest of the nation when it comes to dental care for children.

In the past dozen years the state has doubled the number of Medicaid children receiving dental services, said Kamyar Nasseh, an economist from the American Dental Association. Nasseh spoke at the Oral Health Kansas conference held here last week.

Nasseh said about 20 percent of Kansas children on Medicaid logged a dental visit in 2000. But in 2012, that figure was up to 40 percent, he said, citing statistics from the federal Centers for Medicare and Medicaid Services.

One explanation for the greater percentage of Kansas Medicaid children seeing a dentist could be the state’s school-based screening and sealant program, said Jennifer Ferguson, manager of the Kansas Children’s Oral Health Program. The program targets low-income students.

The program screened approximately 154,000 students during the 2012-2013 school year, more than double the number served just three years prior, according to a presentation by Ferguson.

But despite the improvements, the Kansas percentage remains slightly below the national average, Nasseh said.

Yesterday, KHI News Service reported that Kansas’ Medicaid-reform program, known as KanCare, had effectively shut down a grant-funded initiative that provided Medicaid dental services to children in Head Start programs.

<img src=”http://media.khi.org/img/photos/2013/11/12/2013KansasOralHealthSnapshotTN.jpg” /><br clear=”all” />

The first-ever county-by-county oral health snapshot of Kansas was unveiled at the 2013 Oral Health Kansas conference.

→ Interactive website

→ Download the snapshot (PDF, 7MB)

Nasseh gave the keynote speech at the two-day conference, which drew about 160 people. It was held at Johnson County Community College.

Nasseh cited other Kansas figures:

• Approximately 49 percent of low-income adults saw a dentist in 2010, down from about 53 percent in 2002. There was a similar decline in the national percentage.
• Assuming full implementation of the federal health-reform law, approximately 545,000 Kansas children would have dental benefits by 2018, a roughly 16 percent increase over 2010. A key requirement of the law is that private health insurance plans must include pediatric dental and vision benefits starting next year.
• The Medicaid reimbursement rate for dental services is less than half (46.9 percent) the commercial payment rate, which is about in line with the national average of 50.3 percent.

And he described a national survey by the dental association that found that more than a third of dentists reported they were not busy enough and could accept more patients.<a name=”continued”></a>

Conference presentations are available online, along with the first-ever county-by-county oral health snapshot of the state, which was produced by Oral Health Kansas and released at the conference.

90 percent of counties short on dental providers

Tanya Dorf Brunner, executive director of Oral Health Kansas, said she was surprised to hear that given that 95 of Kansas’ 105 counties do not have enough dental providers.

Members of an oral health task force established by the Kansas Board of Regents recommended last year that the state open a dental school to help address the shortage.

The disconnect between the findings in the dental association survey and the Kansas statistics could boil down to differences among safety-net providers and private-practice dentists, said Dr. Becky Smith, an assistant clinical professor at the University Missouri-Kansas City School of Dentistry.

The dentists she knows working in federally qualified health centers are booked out months in advance, she said.

Smith also said there could be a temporary glut of private practitioners as some dentists delayed retirement because of the recession.

One other reason some dentists might not be busy is that after the recession of 2008 people can’t afford it, said Dr. John Fales, a pediatric dentist in Olathe.

“I think people just stopped going because they could not afford it,” he said.

Nasseh said dentists could play a major role in improving the coordination of all types of medical care, because they often are the first or only medical professional a person might see.

According to federal data from 2011, approximately 27 million Americans visited a dentist that year but did not see a primary care physician.

Some research suggests that oral health professionals could save the health care system millions of dollars by screening for chronic diseases, such as diabetes and hypertension, and allowing for early intervention among patients who might not realize they have those conditions, Nasseh said.

“There are a lot of moving parts going on in dentistry right now,” Nasseh said. “Because of these changes, we expect the profession to change in significant ways in the next 10 to 15 years.”