Tuesday, July 21, 2009

Dentist shortage, made worse by difference in Medicaid and private fees, grows in upstate N.Y.

Shortages of physicians and specialists rural areas have long plagued rural America, but a growing number of areas are also facing a dwindling number of dentists. Patti Singer reports for the Democrat and Chronicle in Rochester that the trend has reached the Finger Lakes region of New York, where at least 10 rural counties face below-average ratios of dentists to patients, exacerbating the problem of few dentists accepting Medicaid for the poor and disabled.

The dentist shortage and limits on Medicaid payments mean residents may go for years without dental care, putting them at risk for gum disease, heart disease and difficulty managing diabetes, among other conditions. Mobile clinics have offered some relief, but residents also face limited transportation for appointments. Singer reports that the solution will likely require higher reimbursement rates and loan forgiveness.

Andrea Haradon, a consultant/coordinator of the S2AY Rural Health Network, worked with the Finger Lakes Health Systems Agency to quantify the problem in New York and says part of the issue is low Medicaid reimbursements. Only 20 percent of dentists in the rural counties studied will accept Medicaid. One, Dr. Michael Keating, works in Cayuga County and says Medicaid pays one-half to one-third the fees paid by private insurance, forcing him and his colleagues to cut off patients."We have to be selective about how many people we can take," he said. "Other people in my area do the same." (Read more)

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