As demand for dental care soars, Medicaid providers struggle to find an empty chair – The Virginian-Pilot

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The dental clinic was buzzing with activity on Friday afternoon.

The Augusta Regional Dental Clinic in Fishersville, like many others serving Medicaid clients across Virginia, has been very busy for months, especially as more and more people have learned about the extended benefits for adults, according to Sophie Parson, director of the clinic.

The need for services is so great that people have called the clinic to try to get an appointment from Louisa County, about 60 miles away.

On July 1, Medicaid began covering more dental procedures following Virginia’s decision to expand Medicaid eligibility under former Governor Ralph Northam’s administration.

“But there’s no one to deliver,” Parson said.

The number of dental providers accepting Medicaid patients fell to 1,888 from a peak of 2,031 in 2017, according to data provided by the Virginia Department of Medical Assistance Services.

“It gets to the point where people refuse to use the benefits to get seen faster,” Parson said.

The procedures often consist not only of minor cleaning or maintenance, but also of serious health problems, such as an infected tooth.

“They need a lot of work and they need it now,” Parson said.

Staff at other dental clinics across the Commonwealth, such as in Suffolk, have also said they are struggling to keep up with demand for services.

DMAS is looking to bring more providers into the fold to shorten waiting lists and connect Virginians to new services, according to director Karen Kimsey.

She said the department is “excited” to provide the new treatments and procedures, especially in cases where Virginians may never have been able to get dental care.

“Oral care is health care,” Kimsey said.

The services are now available to more than 136,000 Virginia Medicaid members, according to Kimsey.

“In the past we had services for adults, but it was mainly for children and pregnant women,” she said.

A major part of the expansion was to cover more than just extractions for Medicaid patients with bad teeth, according to Kimsey. Since July 1, there have been nearly 170,000 Medicaid member tooth restoration treatments, including deposits and crowns, she said.

Facilities such as the Western Tidewater Free Clinic in Suffolk have plans in place to expand services, but these are not happening overnight, according to Ashley Greene, director of development,

“There’s a gap between need and availability, that’s what I would 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 by the spring and summer of 2023,” Greene said. “It can’t happen soon enough.”

In and around Goochland, west of Richmond, the GoochlandCares Clinic began the process of becoming a Medicaid dental provider last year after realizing the lack of care that would occur in the area, according to an e- email from Adina Keys, director of the clinic.

“We learned last summer that approximately 1,300 Goochlanders would be eligible for Medicaid in our county,” she said. “A survey of the few dentists in our area showed that none would accept new Medicaid patients.”

In Richmond, staff at Virginia’s only dental school said they were also struggling to keep up with the new demand.

“Additionally, current reimbursement rates that have not increased for about 15 years sometimes fail to cover the true cost of providing care,” said dentist Lyndon Cooper, dean of the VCU School of Dentistry. “It challenges us and all other oral healthcare providers to operate in a fiscally responsible manner.”

In the past nine months, there has been a 67% increase in the number of Medicaid patients over the age of 21 visiting VCU Dental Care, compared to the same period last year before the expansion, said Donnie Parris, Director of Patient Services. and financial analyst at VCU Dental Care.

“We have also seen an increase in demand for restorative and prosthodontic treatments as more patients have had access to extensive comprehensive dental coverage,” he said.

It also presented an opportunity for students at the institution to train in more specialized areas such as endodontics and prosthodontics, the dentist said. Richard Archer, senior associate dean of clinical education at the 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 of oral health care on the lives of those who have never had access to it, as well as the realities of billing and the different reimbursement rates provided by insurers. “, said Archer. “We are committed to finding solutions that build on the progress made, including bringing more providers into the equation to meet the oral health needs of our communities.”

On Feb. 12, the Augusta Regional Dental Clinic opened a waiting list, and as of last week there were more than 200 people on it, according to Parson. And while, like other clinics, they will prioritize patients based on need, that still means those with a serious problem could wait weeks or even months to be seen.

“It’s 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 the end of his rope.

“What else can we do?” she says. “It’s really tragic. There is no other word.

Ian Munro, [email protected]

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