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Medicaid Program Cuts Back on Idaho Dentists

Roughly 150 dentists have been cut from the Idaho program that provides dental services to Medicaid patients, and the dentists said that will make it harder for those people to get dental care.

Boise pediatric dentist Roy Rogers said he’ll lose more than half his patients when the new Idaho Smiles network goes into effect next month. The Idaho Dental Association said DentaQuest, the subcontractor that administers the provider network, is trying to control costs by cutting the biggest providers of Medicaid dental services.

Rogers said he already represented a bargain for the network—providing some services, like sealant and upgrading to white fillings instead of amalgam fillings—for free to Medicaid patients. The work was more about providing a service than it was about money, he said.

DentaQuest spokeswoman Amy Nelson told The Idaho Statesman that the company wouldn’t give details about how many dentists will remain in the network. The company will meet the state’s contractual access requirements, however, she said.

The contract calls for patients to have access to care within 30 miles of their home, get a routine checkup within 45 days of calling, and receive emergency care within 24 hours of calling.

“It is simply too early to be specific about the ultimate size of our dental network, but there clearly are economies of scale that are possible while maintaining access to high-quality dental care,” Nelson wrote in an e-mail.

But Quinn Dufurrena, executive director of the Idaho Dental Association, said the switch won’t pay off for patients.

“What they’re doing is that they’re creating such obstacles to the Medicaid patients so they won’t use services,” said Dufurrena.

Tom Shanahan, spokesman for the Idaho Department of Health and Welfare, said the subcontractor is simply trying to provide the required care with less funding. The program covers about 190,000 Idaho residents, including adults and children with disabilities and low-income residents. The contract has paid out about $40 million in claims this year.

“They’re looking for providers who will give them the most value,” said Tom Shanahan, spokesman for Idaho Health and Welfare. “They do get to develop the network. It’s their discretion.”

The Idaho Dental Association said money could have been saved in other ways—such as limiting the variety of services offered to Medicaid patients.

Now Rogers said he fears thousands of kids will have difficulty finding new dentists. Many general dentists are unwilling to take the kids on as clients, because the reimbursement rates only cover about 40 cents per dollar, he said.

“This will only create greater barriers to access,” Rogers said.


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