Why are California Republicans Prioritizing Dental Care for the Poor?
Whaaaa? Little Evidence that Flossing Works
Denti-Cal Program 'Dysfunctional' Says Scathing Bipartisan Report
Even With Insurance, Medicaid Recipients Still Go to ER for Dental Problems
State Expands Dental Coverage for Poor — But Getting Treatment Is Another Matter
Website Brings Discounts, Cost Transparency to Dental Care
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But this month, Republicans proposed a bill that would put $200 million dollars toward improving Denti-Cal, the state’s free dental care program for the poor.\u003c/p>\n\u003cp>“If you have a program that already exists that isn’t properly funded, and isn’t working properly, you should fix that first before spending money on new programs,” said Chad Mayes, an Assembly Republican leader who represents Yucca Valley.\u003c/p>\n\u003cp>About 13 million Californians are eligible for Denti-Cal, including 5 million children. But the program is widely viewed as “broken,\" \"bureaucratically rigid,\" and \"a disaster,” according to \u003ca href=\"http://www.lhc.ca.gov/studies/230/Report230.pdf\">a 2016 report\u003c/a> from the \u003ca href=\"http://www.lhc.ca.gov/index.html\" target=\"_blank\">Little Hoover Commission\u003c/a>, an independent state oversight agency.\u003c/p>\n\u003cp>Most people who have Denti-Cal never actually see the dentist, because they can’t find one who accepts their coverage. Eleven counties in California have no dentists who accept Denti-Cal or who are accepting new Denti-Cal patients, according to a 2014 \u003ca href=\"https://www.auditor.ca.gov/reports/summary/2013-125\">California State Auditor report\u003c/a>.\u003c/p>\n\u003cp>“And we just think that that’s wrong,” Mayes said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Many dentists limit the number of Denti-Cal patients they see, or stop seeing them altogether because the pay is too low: California’s reimbursement rates are 35 percent of the national average.\u003c/p>\n\u003cp>The Republican bill, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180AB15\">AB 15\u003c/a>, would put all $200 million into paying dentists a better rate, in the hopes of attracting more dentists to participate in the program.\u003c/p>\n\u003cp>“We need to make it as efficient and effective as possible, so that millions of adults and kids in California that aren’t able to receive dental services are able to get them,” Mayes said.\u003c/p>\n\u003cp>But it's not clear that giving dentists more money actually results in more patients getting care.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.lhc.ca.gov/studies/230/Report230.pdf\" target=\"_blank\">report\u003c/a> from the Little Hoover Commission – a report Mayes and other Republicans cite frequently in defending their bill – includes 11 recommendations on how to fix Denti-Cal.\u003c/p>\n\u003cp>Not one of the recommendations involves increasing payments to dentists. In fact, the report calls across-the-board rate hikes a “costly” move that would result in attracting only “a few more Denti-Cal providers.”\u003c/p>\n\u003cp>Instead, the report recommends improving the Denti-Cal program by simplifying paperwork, focusing on less expensive prevention strategies (like having pediatricians teach patients about good oral hygiene), and establishing dental clinics inside schools or community centers in remote areas, so that patients can go to a centrally located place for care, rather than traveling 60 miles to a dentist’s office.\u003c/p>\n\u003cp>Senate Republican Leader Jean Fuller, who represents Kern County, acknowledged that the bill doesn’t address those recommendations.\u003c/p>\n\u003cp>“Yes, there are a lot of things that I would like to fix about the program. But I am not the majority party, unfortunately. I am not likely to get to adjust those,” she said. “There are 120,000 children in my district who are not getting the service. So my job is to fight for my children to get what I can.\"\u003c/p>\n\u003cp>Paying dentists more money is really about making dentists happy, says Jessica Levinson, a professor at Loyola Law School in Los Angeles.\u003c/p>\n\u003cp>“It’s certainly a Republican goal to be business friendly,” she said. “This proposal is actually a business-friendly, a professional-friendly proposal to try and say to a dentist, ‘You will get higher reimbursement rates and you will be able to serve poor clients.’”\u003c/p>\n\u003cp>Levinson says there could also be something else at play here: campaign money. The \u003ca href=\"http://www.cda.org/\" target=\"_blank\">California Dental Association\u003c/a> gives more to Democrats in the state, but compared to other similar interest groups, like the California Medical Association, the dental group gives more generously to Republicans.\u003c/p>\n\u003cp>When it comes to Californian candidates running for federal office, in the most recent election cycle, the Dental Association gave exclusively to the Republican party, according to \u003ca href=\"https://www.opensecrets.org/pacs/lookup2.php?strID=C00005751&cycle=2016\">campaign contribution data\u003c/a> from Open Secrets. That's a complete turnaround from 25 years ago, when the Association gave only to Democrats running at that level.\u003c/p>\n\u003cp>\"It’s obvious to me that state office holders in California would be well aware of the fact that the California Dental Association is spending a lot of money for Republican candidates on the federal level,” Levinson said, “So they may be hoping that that money will soon come their way.”\u003c/p>\n\u003cp>Republicans and Democrats both are always on the lookout for new sources of campaign money. Asked if the Dental Association’s shift in giving influenced the Republican bill, Assemblyman Chad Mayes said he wasn’t aware of the shift.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Actually, I’m a bit offended by even asking the question, because we really, genuinely care about the people of California,” he said. “This is about fixing a broken governmental program.”\u003c/p>\n\n","blocks":[],"excerpt":"Republicans want to fix the state's Denti-Cal program. But will their strategy help patients or enrich dentists?","status":"publish","parent":0,"modified":1482522406,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":23,"wordCount":838},"headData":{"title":"Why are California Republicans Prioritizing Dental Care for the Poor? | KQED","description":"Republicans want to fix the state's Denti-Cal program. But will their strategy help patients or enrich dentists?","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Why are California Republicans Prioritizing Dental Care for the Poor?","datePublished":"2016-12-22T09:00:46.000Z","dateModified":"2016-12-23T19:46:46.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"273659 http://ww2.kqed.org/stateofhealth/?p=273659","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/12/22/why-are-california-republicans-prioritizing-dental-care-for-the-poor/","disqusTitle":"Why are California Republicans Prioritizing Dental Care for the Poor?","path":"/stateofhealth/273659/why-are-california-republicans-prioritizing-dental-care-for-the-poor","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Democrats have traditionally been the ones to champion health care programs for low-income Californians. But this month, Republicans proposed a bill that would put $200 million dollars toward improving Denti-Cal, the state’s free dental care program for the poor.\u003c/p>\n\u003cp>“If you have a program that already exists that isn’t properly funded, and isn’t working properly, you should fix that first before spending money on new programs,” said Chad Mayes, an Assembly Republican leader who represents Yucca Valley.\u003c/p>\n\u003cp>About 13 million Californians are eligible for Denti-Cal, including 5 million children. But the program is widely viewed as “broken,\" \"bureaucratically rigid,\" and \"a disaster,” according to \u003ca href=\"http://www.lhc.ca.gov/studies/230/Report230.pdf\">a 2016 report\u003c/a> from the \u003ca href=\"http://www.lhc.ca.gov/index.html\" target=\"_blank\">Little Hoover Commission\u003c/a>, an independent state oversight agency.\u003c/p>\n\u003cp>Most people who have Denti-Cal never actually see the dentist, because they can’t find one who accepts their coverage. Eleven counties in California have no dentists who accept Denti-Cal or who are accepting new Denti-Cal patients, according to a 2014 \u003ca href=\"https://www.auditor.ca.gov/reports/summary/2013-125\">California State Auditor report\u003c/a>.\u003c/p>\n\u003cp>“And we just think that that’s wrong,” Mayes said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Many dentists limit the number of Denti-Cal patients they see, or stop seeing them altogether because the pay is too low: California’s reimbursement rates are 35 percent of the national average.\u003c/p>\n\u003cp>The Republican bill, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180AB15\">AB 15\u003c/a>, would put all $200 million into paying dentists a better rate, in the hopes of attracting more dentists to participate in the program.\u003c/p>\n\u003cp>“We need to make it as efficient and effective as possible, so that millions of adults and kids in California that aren’t able to receive dental services are able to get them,” Mayes said.\u003c/p>\n\u003cp>But it's not clear that giving dentists more money actually results in more patients getting care.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.lhc.ca.gov/studies/230/Report230.pdf\" target=\"_blank\">report\u003c/a> from the Little Hoover Commission – a report Mayes and other Republicans cite frequently in defending their bill – includes 11 recommendations on how to fix Denti-Cal.\u003c/p>\n\u003cp>Not one of the recommendations involves increasing payments to dentists. In fact, the report calls across-the-board rate hikes a “costly” move that would result in attracting only “a few more Denti-Cal providers.”\u003c/p>\n\u003cp>Instead, the report recommends improving the Denti-Cal program by simplifying paperwork, focusing on less expensive prevention strategies (like having pediatricians teach patients about good oral hygiene), and establishing dental clinics inside schools or community centers in remote areas, so that patients can go to a centrally located place for care, rather than traveling 60 miles to a dentist’s office.\u003c/p>\n\u003cp>Senate Republican Leader Jean Fuller, who represents Kern County, acknowledged that the bill doesn’t address those recommendations.\u003c/p>\n\u003cp>“Yes, there are a lot of things that I would like to fix about the program. But I am not the majority party, unfortunately. I am not likely to get to adjust those,” she said. “There are 120,000 children in my district who are not getting the service. So my job is to fight for my children to get what I can.\"\u003c/p>\n\u003cp>Paying dentists more money is really about making dentists happy, says Jessica Levinson, a professor at Loyola Law School in Los Angeles.\u003c/p>\n\u003cp>“It’s certainly a Republican goal to be business friendly,” she said. “This proposal is actually a business-friendly, a professional-friendly proposal to try and say to a dentist, ‘You will get higher reimbursement rates and you will be able to serve poor clients.’”\u003c/p>\n\u003cp>Levinson says there could also be something else at play here: campaign money. The \u003ca href=\"http://www.cda.org/\" target=\"_blank\">California Dental Association\u003c/a> gives more to Democrats in the state, but compared to other similar interest groups, like the California Medical Association, the dental group gives more generously to Republicans.\u003c/p>\n\u003cp>When it comes to Californian candidates running for federal office, in the most recent election cycle, the Dental Association gave exclusively to the Republican party, according to \u003ca href=\"https://www.opensecrets.org/pacs/lookup2.php?strID=C00005751&cycle=2016\">campaign contribution data\u003c/a> from Open Secrets. That's a complete turnaround from 25 years ago, when the Association gave only to Democrats running at that level.\u003c/p>\n\u003cp>\"It’s obvious to me that state office holders in California would be well aware of the fact that the California Dental Association is spending a lot of money for Republican candidates on the federal level,” Levinson said, “So they may be hoping that that money will soon come their way.”\u003c/p>\n\u003cp>Republicans and Democrats both are always on the lookout for new sources of campaign money. Asked if the Dental Association’s shift in giving influenced the Republican bill, Assemblyman Chad Mayes said he wasn’t aware of the shift.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Actually, I’m a bit offended by even asking the question, because we really, genuinely care about the people of California,” he said. “This is about fixing a broken governmental program.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/273659/why-are-california-republicans-prioritizing-dental-care-for-the-poor","authors":["3205"],"categories":["stateofhealth_11","stateofhealth_14"],"tags":["stateofhealth_380","stateofhealth_2621","stateofhealth_2808","stateofhealth_2519","stateofhealth_3010"],"featImg":"stateofhealth_273776","label":"stateofhealth"},"stateofhealth_220340":{"type":"posts","id":"stateofhealth_220340","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"220340","score":null,"sort":[1470161391000]},"guestAuthors":[],"slug":"whaaaa-little-evidence-that-flossing-works","title":"Whaaaa? Little Evidence that Flossing Works","publishDate":1470161391,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>It's one of the most universal recommendations in all of public health: Floss daily to prevent gum disease and cavities.\u003c/p>\n\u003cp>Except there's little proof that flossing works.\u003c/p>\n\u003caside class=\"pullquote alignright\">In a letter to the Associated Press, the federal government acknowledged the effectiveness of flossing had never been researched, as required.\u003c/aside>\n\u003cp>Still, the federal government, dental organizations and manufacturers of floss have pushed the practice for decades. Dentists provide samples to their patients, and the American Dental Association insists on its website that \"flossing is an essential part of taking care of your teeth and gums.\"\u003c/p>\n\u003cp>The federal government has recommended flossing since 1979, first in a surgeon general's report and later in the Dietary Guidelines for Americans issued every five years. The guidelines must be based on scientific evidence, under the law.\u003c/p>\n\u003cp>Last year, the Associated Press asked the departments of Health and Human Services and Agriculture for their evidence, and followed up with written requests under the Freedom of Information Act.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>When the federal government issued its latest dietary guidelines this year, the flossing recommendation had been removed, without notice. In a letter to the AP, the government acknowledged the effectiveness of flossing had never been researched, as required.\u003c/p>\n\u003cp>The AP looked at the most rigorous research conducted over the past decade, focusing on 25 studies that generally compared the use of a toothbrush with the combination of toothbrushes and floss. The findings? The evidence for flossing is \"weak, very unreliable,\" of \"very low\" quality, and carries \"a moderate to large potential for bias.\"\u003c/p>\n\u003cp>\"The majority of available studies fail to demonstrate that flossing is generally effective in plaque removal,\" said one review conducted last year. Another 2015 review cites \"inconsistent/weak evidence\" for flossing and a \"lack of efficacy.\"\u003c/p>\n\u003cp>One study review in 2011 did credit floss with a slight reduction in gum inflammation — which can sometimes develop over time into full-fledged gum disease. However, the reviewers ranked the evidence as \"very unreliable.\" A commentary in a dental magazine stated that any benefit would be so minute it might not be noticed by users.\u003c/p>\n\u003cp>The two leading professional groups — the American Dental Association and the American Academy of Periodontology, for specialists in gum disease and implants — cited other studies as proof of their claims that flossing prevents buildup of gunk known as plaque, early gum inflammation called gingivitis and tooth decay. However, most of these studies used outdated methods or tested few people. Some lasted only two weeks, far too brief for a cavity or dental disease to develop. One tested 25 people after only a single use of floss. Such research, like the reviewed studies, focused on warning signs like bleeding and inflammation, barely dealing with gum disease or cavities.\u003c/p>\n\u003cp>Wayne Aldredge, president of the periodontists' group, acknowledged the weak scientific evidence and the brief duration of many studies. In an interview at his private practice in New Jersey, he said that the impact of floss might be clearer if researchers focused on patients at highest risk of gum disease, such as diabetics and smokers.\u003c/p>\n\u003cp>Still, he urges his patients to floss to help avoid gum disease. \"It's like building a house and not painting two sides of it,\" he said. \"Ultimately those two sides are going to rot away quicker.\"\u003c/p>\n\u003cp>Aldredge also said many people use floss incorrectly, moving it in a sawing motion instead of up and down the sides of the teeth. Pressed about the origins of his organization's endorsement of flossing, he said it may simply have \"taken the ADA's lead.\"\u003c/p>\n\u003cp>When the ADA was asked for proof of its claim that flossing helps prevent early gum disease and cavities, the group cited the 2011 review and a 2008 two-week study that measured bacteria and did not even consider gum disease.\u003c/p>\n\u003cp>In a later statement to the AP, the ADA said flossing \"removes plaque\" and \"is proven to help remove\" debris from between teeth. A video on its website proclaims that flossing \"helps prevent gum disease.\" When pressed, Matthew J. Messina, a practicing dentist and spokesman for the dental association, acknowledged weak evidence, but he blamed research participants who didn't floss correctly.\u003c/p>\n\u003cp>Even companies with a big market share of the flossing business — by next year, the global market is predicted to reach almost $2 billion, with half in the United States, according to publisher MarketSizeInfo.com — struggled to provide convincing evidence of their claims that floss reduces plaque or gingivitis. Yet the industry has paid for most studies and sometimes designed and conducted the research.\u003c/p>\n\u003cp>Procter & Gamble, which claims that its floss fights plaque and gingivitis, pointed to a two-week study, which was discounted as irrelevant in the 2011 research review.\u003c/p>\n\u003cp>Johnson & Johnson spokesman Marc Boston said floss helps remove plaque. When the AP sent him a list of contradicting studies, he declined comment.\u003c/p>\n\u003cp>The floss-making companies partner with the ADA through its Seal of Acceptance program. The ADA promotes the seal to companies as something that \"directly affects the purchase decisions of consumers,\" and each manufacturer is charged $14,500 for the evaluation. If it approves the product, the ADA then charges an additional annual fee of $3,500.\u003c/p>\n\u003cp>The ADA says it rigorously evaluates products and makes no profit from the program. However, floss companies themselves are allowed to design the studies.\u003c/p>\n\u003cp>\"The funding can come from companies — no problem at all,\" said dentist Marcelo W.B. Araujo, vice president of the ADA's Science Institute, who joined the organization after serving as an executive for Johnson & Johnson. \"The design can start from the company.\"\u003c/p>\n\u003cp>When flossing first gained acceptance, no proof was required of remedies. Dentist Levi Spear Parmly is credited with inventing floss in the early 19th century. By the time the first floss patent was issued, in 1874, the applicant noted that dentists were widely recommending its use.\u003c/p>\n\u003cp>The ADA has been promoting floss universally since 1908. \"They just looked into what they did every day in their clinical practice and what they would recommend for patients,\" said Araujo.\u003c/p>\n\u003cp>Count dentist Damien Walmsley, scientific adviser to the British Dental Association, among the skeptics. \"It's important to tell people to do the basics. Flossing is not part of the basics.\"\u003c/p>\n\u003cp>Floss can occasionally cause harm. Careless flossing can damage gums, teeth and dental work. Though frequency is unclear, floss can dislodge bad bacteria that invade the bloodstream and cause dangerous infections, especially in people with weak immunity, according to the medical literature.\u003c/p>\n\u003cp>National Institutes of Health dentist Tim Iafolla acknowledged that if the highest standards of science were applied in keeping with the flossing reviews of the past decade, \"then it would be appropriate to drop the floss guidelines.\"\u003c/p>\n\u003cp>Regardless, he added, Americans should still floss.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"It's low risk, low cost,\" he said. \"We know there's a possibility that it works, so we feel comfortable telling people to go ahead and do it.\"\u003c/p>\n\n","blocks":[],"excerpt":"The Associated Press reviewed the existing data -- and couldn't find much that supported the benefits of flossing.","status":"publish","parent":0,"modified":1470178542,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":30,"wordCount":1170},"headData":{"title":"Whaaaa? Little Evidence that Flossing Works | KQED","description":"The Associated Press reviewed the existing data -- and couldn't find much that supported the benefits of flossing.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Whaaaa? Little Evidence that Flossing Works","datePublished":"2016-08-02T18:09:51.000Z","dateModified":"2016-08-02T22:55:42.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"220340 http://ww2.kqed.org/stateofhealth/?p=220340","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/08/02/whaaaa-little-evidence-that-flossing-works/","disqusTitle":"Whaaaa? Little Evidence that Flossing Works","nprByline":"Jeff Donn \u003cbr /> Associated Press","path":"/stateofhealth/220340/whaaaa-little-evidence-that-flossing-works","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>It's one of the most universal recommendations in all of public health: Floss daily to prevent gum disease and cavities.\u003c/p>\n\u003cp>Except there's little proof that flossing works.\u003c/p>\n\u003caside class=\"pullquote alignright\">In a letter to the Associated Press, the federal government acknowledged the effectiveness of flossing had never been researched, as required.\u003c/aside>\n\u003cp>Still, the federal government, dental organizations and manufacturers of floss have pushed the practice for decades. Dentists provide samples to their patients, and the American Dental Association insists on its website that \"flossing is an essential part of taking care of your teeth and gums.\"\u003c/p>\n\u003cp>The federal government has recommended flossing since 1979, first in a surgeon general's report and later in the Dietary Guidelines for Americans issued every five years. The guidelines must be based on scientific evidence, under the law.\u003c/p>\n\u003cp>Last year, the Associated Press asked the departments of Health and Human Services and Agriculture for their evidence, and followed up with written requests under the Freedom of Information Act.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>When the federal government issued its latest dietary guidelines this year, the flossing recommendation had been removed, without notice. In a letter to the AP, the government acknowledged the effectiveness of flossing had never been researched, as required.\u003c/p>\n\u003cp>The AP looked at the most rigorous research conducted over the past decade, focusing on 25 studies that generally compared the use of a toothbrush with the combination of toothbrushes and floss. The findings? The evidence for flossing is \"weak, very unreliable,\" of \"very low\" quality, and carries \"a moderate to large potential for bias.\"\u003c/p>\n\u003cp>\"The majority of available studies fail to demonstrate that flossing is generally effective in plaque removal,\" said one review conducted last year. Another 2015 review cites \"inconsistent/weak evidence\" for flossing and a \"lack of efficacy.\"\u003c/p>\n\u003cp>One study review in 2011 did credit floss with a slight reduction in gum inflammation — which can sometimes develop over time into full-fledged gum disease. However, the reviewers ranked the evidence as \"very unreliable.\" A commentary in a dental magazine stated that any benefit would be so minute it might not be noticed by users.\u003c/p>\n\u003cp>The two leading professional groups — the American Dental Association and the American Academy of Periodontology, for specialists in gum disease and implants — cited other studies as proof of their claims that flossing prevents buildup of gunk known as plaque, early gum inflammation called gingivitis and tooth decay. However, most of these studies used outdated methods or tested few people. Some lasted only two weeks, far too brief for a cavity or dental disease to develop. One tested 25 people after only a single use of floss. Such research, like the reviewed studies, focused on warning signs like bleeding and inflammation, barely dealing with gum disease or cavities.\u003c/p>\n\u003cp>Wayne Aldredge, president of the periodontists' group, acknowledged the weak scientific evidence and the brief duration of many studies. In an interview at his private practice in New Jersey, he said that the impact of floss might be clearer if researchers focused on patients at highest risk of gum disease, such as diabetics and smokers.\u003c/p>\n\u003cp>Still, he urges his patients to floss to help avoid gum disease. \"It's like building a house and not painting two sides of it,\" he said. \"Ultimately those two sides are going to rot away quicker.\"\u003c/p>\n\u003cp>Aldredge also said many people use floss incorrectly, moving it in a sawing motion instead of up and down the sides of the teeth. Pressed about the origins of his organization's endorsement of flossing, he said it may simply have \"taken the ADA's lead.\"\u003c/p>\n\u003cp>When the ADA was asked for proof of its claim that flossing helps prevent early gum disease and cavities, the group cited the 2011 review and a 2008 two-week study that measured bacteria and did not even consider gum disease.\u003c/p>\n\u003cp>In a later statement to the AP, the ADA said flossing \"removes plaque\" and \"is proven to help remove\" debris from between teeth. A video on its website proclaims that flossing \"helps prevent gum disease.\" When pressed, Matthew J. Messina, a practicing dentist and spokesman for the dental association, acknowledged weak evidence, but he blamed research participants who didn't floss correctly.\u003c/p>\n\u003cp>Even companies with a big market share of the flossing business — by next year, the global market is predicted to reach almost $2 billion, with half in the United States, according to publisher MarketSizeInfo.com — struggled to provide convincing evidence of their claims that floss reduces plaque or gingivitis. Yet the industry has paid for most studies and sometimes designed and conducted the research.\u003c/p>\n\u003cp>Procter & Gamble, which claims that its floss fights plaque and gingivitis, pointed to a two-week study, which was discounted as irrelevant in the 2011 research review.\u003c/p>\n\u003cp>Johnson & Johnson spokesman Marc Boston said floss helps remove plaque. When the AP sent him a list of contradicting studies, he declined comment.\u003c/p>\n\u003cp>The floss-making companies partner with the ADA through its Seal of Acceptance program. The ADA promotes the seal to companies as something that \"directly affects the purchase decisions of consumers,\" and each manufacturer is charged $14,500 for the evaluation. If it approves the product, the ADA then charges an additional annual fee of $3,500.\u003c/p>\n\u003cp>The ADA says it rigorously evaluates products and makes no profit from the program. However, floss companies themselves are allowed to design the studies.\u003c/p>\n\u003cp>\"The funding can come from companies — no problem at all,\" said dentist Marcelo W.B. Araujo, vice president of the ADA's Science Institute, who joined the organization after serving as an executive for Johnson & Johnson. \"The design can start from the company.\"\u003c/p>\n\u003cp>When flossing first gained acceptance, no proof was required of remedies. Dentist Levi Spear Parmly is credited with inventing floss in the early 19th century. By the time the first floss patent was issued, in 1874, the applicant noted that dentists were widely recommending its use.\u003c/p>\n\u003cp>The ADA has been promoting floss universally since 1908. \"They just looked into what they did every day in their clinical practice and what they would recommend for patients,\" said Araujo.\u003c/p>\n\u003cp>Count dentist Damien Walmsley, scientific adviser to the British Dental Association, among the skeptics. \"It's important to tell people to do the basics. Flossing is not part of the basics.\"\u003c/p>\n\u003cp>Floss can occasionally cause harm. Careless flossing can damage gums, teeth and dental work. Though frequency is unclear, floss can dislodge bad bacteria that invade the bloodstream and cause dangerous infections, especially in people with weak immunity, according to the medical literature.\u003c/p>\n\u003cp>National Institutes of Health dentist Tim Iafolla acknowledged that if the highest standards of science were applied in keeping with the flossing reviews of the past decade, \"then it would be appropriate to drop the floss guidelines.\"\u003c/p>\n\u003cp>Regardless, he added, Americans should still floss.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"It's low risk, low cost,\" he said. \"We know there's a possibility that it works, so we feel comfortable telling people to go ahead and do it.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/220340/whaaaa-little-evidence-that-flossing-works","authors":["byline_stateofhealth_220340"],"categories":["stateofhealth_12"],"tags":["stateofhealth_380","stateofhealth_2808","stateofhealth_2833","stateofhealth_2519"],"featImg":"stateofhealth_220346","label":"stateofhealth"},"stateofhealth_168411":{"type":"posts","id":"stateofhealth_168411","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"168411","score":null,"sort":[1459798878000]},"guestAuthors":[],"slug":"denti-cal-program-dysfunctional-says-scathing-bipartisan-report","title":"Denti-Cal Program 'Dysfunctional' Says Scathing Bipartisan Report","publishDate":1459798878,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>The State of California’s dental health system for the poor is “dysfunctional” according to a \u003ca href=\"http://www.lhc.ca.gov/studies/230/Report230.pdf\" target=\"_blank\">scathing report\u003c/a> issued Friday by a bipartisan oversight commission.\u003c/p>\n\u003cp>The program, Denti-Cal, “ranks among state government’s greatest deficiencies,” said the report by the \u003ca href=\"http://www.lhc.ca.gov/about/about.html\" target=\"_blank\">Little Hoover Commission\u003c/a>, a statutorily independent oversight agency.\u003c/p>\n\u003caside class=\"pullquote alignright\">'In California we have kids’ teeth rotting out of their heads.'\u003ccite> Pedro Nava, Chairman, Little Hoover Commission \u003c/cite>\u003c/aside>\n\u003cp>The state bureaucracy that runs Denti-Cal draws only part of the blame. The legislature, the governor’s office, and the political culture of California share culpability for decades of neglect and strategic misdirection, the commission says.\u003c/p>\n\u003cp>The program falls “disastrously short in providing dental care to a third of California’s population and more than half of its children.”\u003c/p>\n\u003cp>A more vivid description comes from Pedro Nava, the commission’s chairman:\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“In California we have kids’ teeth rotting out of their heads,” he says. “That’s utterly inexcusable.”\u003c/p>\n\u003cp>\u003cb>Dental Profession 'Thoroughly Alienated'\u003c/b>\u003c/p>\n\u003cp>The report makes grim reading. California faces an “epidemic of tooth disease in which toddlers by the thousands have mouthfuls of cavities, children and adults are plagued with toothaches, whole counties have no Denti-Cal providers and families don’t understand basic preventative dental care,” it said.\u003c/p>\n\u003cp>Meanwhile, Denti-Cal has “thoroughly alienated the dental profession” with tangles of red tape and “reimbursement rates among the nation’s lowest,” the report said.\u003c/p>\n\u003cp>In sum, the commission said it’s time to “reboot” Denti-Cal.\u003c/p>\n\u003cp>[contextly_sidebar id=\"MvOmIplCazK7Ew4ddY2etXumhgCTSgzr\"]The program is run by the state Department of Health Care Services, which oversees Medi-Care, California’s version of Medicaid.\u003c/p>\n\u003cp>The department released a \u003ca href=\"https://californiahealthline.files.wordpress.com/2016/04/californiahealthline-denti-cal-040116.pdf\" target=\"_blank\">lengthy prepared response to questions\u003c/a> from CHL, which includes this statement:\u003c/p>\n\u003cp>“DHCS is strongly committed to providing access to quality dental care for our millions of Medi-Cal members, and Director Jennifer Kent has publicly stated that improving the Denti-Cal program is one of her top priorities.”\u003c/p>\n\u003cp>Nava has heard it before. “I have been completely underwhelmed by the response of the department,” he said. “Their efforts have been far too little and far too late.”\u003c/p>\n\u003cp>It’s not just the department though. Acccording to the report, “Blame goes so much deeper.”\u003c/p>\n\u003cp>“Successive legislatures and administrations,” the commission said, “have underfunded the Denti-Cal program and slashed reimbursement rates for dental providers to national lows. The state has historically lacked any strategy to prevent dental disease among its neediest populations.”\u003c/p>\n\u003cp>Evidence is widespread that bad dental health can seriously affect general health, making more people sick and driving health costs even higher.\u003c/p>\n\u003cp>But in California, there is a Denti-Cal dentist shortage.\u003c/p>\n\u003cp>Many dentists say they lose money on state-funded patients, so caring for them becomes a form of charity work.\u003c/p>\n\u003cp>John Blake is a dentist who gave up a private practice in Long Beach to run the Children’s Dental Health Clinic in Long Beach, where about 85 percent of patients are on Denti-Cal.\u003c/p>\n\u003cp>Blake said he just wants to break even — the business is a non-profit — 25 percent of his overhead is paid for through donations and fund-raising events. It’s impossible to cover costs with the low payments from the state, he said.\u003c/p>\n\u003cp>“A lot of my colleagues used to take Denti-Cal, but it’s not just the low rates, it’s that the hassle of the system is so much worse than reimbursement. The hassle factor just got to be too much,” Blake said. “They just gave up.”\u003c/p>\n\u003cp>Little Hoover more formally addressed the hassle factor, noting that copious pre-authorizations for basic procedures are a major hassle, never mind a a clunky billing system, much of it still paper-based, and a 22-page application form just to participate in the program.\u003c/p>\n\u003cp>Camille Nishikawa is a dentist in Los Angeles who doesn’t have those problems. She runs the QueensCare mobile dental clinic in partnership with USC Medical Center, which travels to the poorest parts of LA to take care of kids’ teeth. The mobile dental van is funded by grants; it doesn’t accept any money from patients or from Denti-Cal.\u003c/p>\n\u003cp>\u003cstrong>Children 'Suffer in Pain'\u003c/strong>\u003c/p>\n\u003cp>Organizational dysfunction is only part of the problem with Denti-Cal, Nishikawa said. Many poor people who are eligible for the program’s benefits don’t even know about them.\u003c/p>\n\u003cp>“A lot of the community isn’t aware of what they’re entitled to,” she said. “And if they do, they don’t know where to go to find a dentist.”\u003c/p>\n\u003cp>[contextly_sidebar id=\"YqwmVIo7HQrzTrqAnpvYUxl7c1QcyMYV\"]Ruth Sandoval is one of those low-income people, a mostly Spanish-speaking mother of two in Los Angeles. She said she had no idea she and her two children could even get dental care as part of their Medi-Cal program. “It has been hard to find a dentist; it’s very hard to find one,” Sandoval said.\u003c/p>\n\u003cp>She went to a clinic in LA for a different health problem and discovered a dentist on staff. She’s grateful for that, she said, because she wouldn’t have a dentist otherwise. “It’s so important to us, we were so happy to find her there,” Sandoval said.\u003c/p>\n\u003cp>Most low-income Californians aren’t that lucky. Only about half of the children eligible for dental coverage actually see a dentist, said Jenny Kattlove of the Santa Monica-based Children’s Partnership advocacy group.\u003c/p>\n\u003cp>She said the severity of the dental problem was accurately outlined in the Little Hoover report, saying it lays out “an ambitious but necessary path” toward revamping the entire low-income dental system.\u003c/p>\n\u003cp>People think of dental care as just getting a teeth-cleaning, and that it’s not seen as a health issue.\u003c/p>\n\u003cp>“Look, when children don’t get the oral health care they need, they suffer in pain,” she said. “Untreated dental problems actually can lead to death, I don’t know what’s more health-related than that.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Nava said access problems may only get worse as more Californians are added to the Medi-Cal rolls. In mid-May, an estimated 170,000 undocumented children will become eligible for full Medi-Cal benefits, including dental care, and Nava worries that they won’t get it.\u003c/p>\n\n","blocks":[],"excerpt":"The report makes grim reading. California faces an “epidemic of tooth disease in which toddlers by the thousands have mouthfuls of cavities.\"","status":"publish","parent":0,"modified":1461188888,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":36,"wordCount":1131},"headData":{"title":"Denti-Cal Program 'Dysfunctional' Says Scathing Bipartisan Report | KQED","description":"The report makes grim reading. California faces an “epidemic of tooth disease in which toddlers by the thousands have mouthfuls of cavities."","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Denti-Cal Program 'Dysfunctional' Says Scathing Bipartisan Report","datePublished":"2016-04-04T19:41:18.000Z","dateModified":"2016-04-20T21:48:08.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"168411 http://ww2.kqed.org/stateofhealth/?p=168411","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/04/04/denti-cal-program-dysfunctional-says-scathing-bipartisan-report/","disqusTitle":"Denti-Cal Program 'Dysfunctional' Says Scathing Bipartisan Report","nprByline":" David Gorn\u003cbr />\u003ca href=\"http://californiahealthline.org/\">California Healthline\u003c/a>","path":"/stateofhealth/168411/denti-cal-program-dysfunctional-says-scathing-bipartisan-report","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The State of California’s dental health system for the poor is “dysfunctional” according to a \u003ca href=\"http://www.lhc.ca.gov/studies/230/Report230.pdf\" target=\"_blank\">scathing report\u003c/a> issued Friday by a bipartisan oversight commission.\u003c/p>\n\u003cp>The program, Denti-Cal, “ranks among state government’s greatest deficiencies,” said the report by the \u003ca href=\"http://www.lhc.ca.gov/about/about.html\" target=\"_blank\">Little Hoover Commission\u003c/a>, a statutorily independent oversight agency.\u003c/p>\n\u003caside class=\"pullquote alignright\">'In California we have kids’ teeth rotting out of their heads.'\u003ccite> Pedro Nava, Chairman, Little Hoover Commission \u003c/cite>\u003c/aside>\n\u003cp>The state bureaucracy that runs Denti-Cal draws only part of the blame. The legislature, the governor’s office, and the political culture of California share culpability for decades of neglect and strategic misdirection, the commission says.\u003c/p>\n\u003cp>The program falls “disastrously short in providing dental care to a third of California’s population and more than half of its children.”\u003c/p>\n\u003cp>A more vivid description comes from Pedro Nava, the commission’s chairman:\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“In California we have kids’ teeth rotting out of their heads,” he says. “That’s utterly inexcusable.”\u003c/p>\n\u003cp>\u003cb>Dental Profession 'Thoroughly Alienated'\u003c/b>\u003c/p>\n\u003cp>The report makes grim reading. California faces an “epidemic of tooth disease in which toddlers by the thousands have mouthfuls of cavities, children and adults are plagued with toothaches, whole counties have no Denti-Cal providers and families don’t understand basic preventative dental care,” it said.\u003c/p>\n\u003cp>Meanwhile, Denti-Cal has “thoroughly alienated the dental profession” with tangles of red tape and “reimbursement rates among the nation’s lowest,” the report said.\u003c/p>\n\u003cp>In sum, the commission said it’s time to “reboot” Denti-Cal.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The program is run by the state Department of Health Care Services, which oversees Medi-Care, California’s version of Medicaid.\u003c/p>\n\u003cp>The department released a \u003ca href=\"https://californiahealthline.files.wordpress.com/2016/04/californiahealthline-denti-cal-040116.pdf\" target=\"_blank\">lengthy prepared response to questions\u003c/a> from CHL, which includes this statement:\u003c/p>\n\u003cp>“DHCS is strongly committed to providing access to quality dental care for our millions of Medi-Cal members, and Director Jennifer Kent has publicly stated that improving the Denti-Cal program is one of her top priorities.”\u003c/p>\n\u003cp>Nava has heard it before. “I have been completely underwhelmed by the response of the department,” he said. “Their efforts have been far too little and far too late.”\u003c/p>\n\u003cp>It’s not just the department though. Acccording to the report, “Blame goes so much deeper.”\u003c/p>\n\u003cp>“Successive legislatures and administrations,” the commission said, “have underfunded the Denti-Cal program and slashed reimbursement rates for dental providers to national lows. The state has historically lacked any strategy to prevent dental disease among its neediest populations.”\u003c/p>\n\u003cp>Evidence is widespread that bad dental health can seriously affect general health, making more people sick and driving health costs even higher.\u003c/p>\n\u003cp>But in California, there is a Denti-Cal dentist shortage.\u003c/p>\n\u003cp>Many dentists say they lose money on state-funded patients, so caring for them becomes a form of charity work.\u003c/p>\n\u003cp>John Blake is a dentist who gave up a private practice in Long Beach to run the Children’s Dental Health Clinic in Long Beach, where about 85 percent of patients are on Denti-Cal.\u003c/p>\n\u003cp>Blake said he just wants to break even — the business is a non-profit — 25 percent of his overhead is paid for through donations and fund-raising events. It’s impossible to cover costs with the low payments from the state, he said.\u003c/p>\n\u003cp>“A lot of my colleagues used to take Denti-Cal, but it’s not just the low rates, it’s that the hassle of the system is so much worse than reimbursement. The hassle factor just got to be too much,” Blake said. “They just gave up.”\u003c/p>\n\u003cp>Little Hoover more formally addressed the hassle factor, noting that copious pre-authorizations for basic procedures are a major hassle, never mind a a clunky billing system, much of it still paper-based, and a 22-page application form just to participate in the program.\u003c/p>\n\u003cp>Camille Nishikawa is a dentist in Los Angeles who doesn’t have those problems. She runs the QueensCare mobile dental clinic in partnership with USC Medical Center, which travels to the poorest parts of LA to take care of kids’ teeth. The mobile dental van is funded by grants; it doesn’t accept any money from patients or from Denti-Cal.\u003c/p>\n\u003cp>\u003cstrong>Children 'Suffer in Pain'\u003c/strong>\u003c/p>\n\u003cp>Organizational dysfunction is only part of the problem with Denti-Cal, Nishikawa said. Many poor people who are eligible for the program’s benefits don’t even know about them.\u003c/p>\n\u003cp>“A lot of the community isn’t aware of what they’re entitled to,” she said. “And if they do, they don’t know where to go to find a dentist.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Ruth Sandoval is one of those low-income people, a mostly Spanish-speaking mother of two in Los Angeles. She said she had no idea she and her two children could even get dental care as part of their Medi-Cal program. “It has been hard to find a dentist; it’s very hard to find one,” Sandoval said.\u003c/p>\n\u003cp>She went to a clinic in LA for a different health problem and discovered a dentist on staff. She’s grateful for that, she said, because she wouldn’t have a dentist otherwise. “It’s so important to us, we were so happy to find her there,” Sandoval said.\u003c/p>\n\u003cp>Most low-income Californians aren’t that lucky. Only about half of the children eligible for dental coverage actually see a dentist, said Jenny Kattlove of the Santa Monica-based Children’s Partnership advocacy group.\u003c/p>\n\u003cp>She said the severity of the dental problem was accurately outlined in the Little Hoover report, saying it lays out “an ambitious but necessary path” toward revamping the entire low-income dental system.\u003c/p>\n\u003cp>People think of dental care as just getting a teeth-cleaning, and that it’s not seen as a health issue.\u003c/p>\n\u003cp>“Look, when children don’t get the oral health care they need, they suffer in pain,” she said. “Untreated dental problems actually can lead to death, I don’t know what’s more health-related than that.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Nava said access problems may only get worse as more Californians are added to the Medi-Cal rolls. In mid-May, an estimated 170,000 undocumented children will become eligible for full Medi-Cal benefits, including dental care, and Nava worries that they won’t get it.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/168411/denti-cal-program-dysfunctional-says-scathing-bipartisan-report","authors":["byline_stateofhealth_168411"],"categories":["stateofhealth_14","stateofhealth_13"],"tags":["stateofhealth_96","stateofhealth_380","stateofhealth_2621","stateofhealth_2519"],"featImg":"stateofhealth_168438","label":"stateofhealth"},"stateofhealth_57722":{"type":"posts","id":"stateofhealth_57722","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"57722","score":null,"sort":[1438880514000]},"guestAuthors":[],"slug":"even-with-insurance-medicaid-recipients-still-go-to-er-for-dental-problems","title":"Even With Insurance, Medicaid Recipients Still Go to ER for Dental Problems","publishDate":1438880514,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>States that provide Medicaid adult dental care still have high rates of dental patients who show up at hospital emergency departments, particularly in urban underserved areas, according to a \u003ca href=\"https://med.stanford.edu/news/all-news/2015/08/medicaid-dental-coverage-may-not-prevent-tooth-related-er-visits.html\" target=\"_blank\">study released this week\u003c/a>. The study -- by researchers at Stanford University, UC San Francisco, Truven Health Analytics and the federal Agency for Healthcare Research and Quality -- was published in \u003cem>\u003ca href=\"http://content.healthaffairs.org/content/34/8/1349.abstract?=right\" target=\"_blank\">Health Affairs\u003c/a>\u003c/em>.\u003c/p>\n\u003caside class=\"pullquote alignright\">“People say there are plenty of dentists, but there’s a subtler argument we’re trying to make: that there is a low rate of dentists who take Medicaid.”\u003c/aside>\n\u003cp>Researchers said a dearth of dental providers who accept Medicaid patients, particularly in those urban underserved areas, has limited the effectiveness of Medicaid dental coverage in states that provide it.\u003c/p>\n\u003cp>\"We found that, in urban counties there were large concentrations of all providers, but not really to serve the poor,\" said Maria Raven, senior author of the study and associate professor of emergency medicine at UCSF.\u003c/p>\n\u003cp>\"There may be a higher density of dentists [in urban areas], but they're still not accepting Medi-Cal patients,\" Raven said. \"Coverage doesn't equal access.\"\u003c/p>\n\u003cp>That has resulted in high ED use even in states with Medicaid dental coverage, she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Medi-Cal is California's Medicaid program, and it did not have adult dental coverage in 2010, when the study's data were collected.\u003c/p>\n\u003cp>Katie Fingar, lead author of the study and research leader in health care at Truven, said the numbers were slightly better in rural areas.\u003c/p>\n\u003cp>\"We did see that for those in rural areas, a greater supply [of dental providers] was associated with lower ED use,\" Fingar said. But, she said, 90 percent of Medicaid dental visits are in urban areas.\u003c/p>\n\u003cp>[contextly_sidebar id=\"sT9KtJ06HSo5xPfgl6TvmZCmlYYDZAHP\"]As a result, she said, more than 2 percent of all emergency department visits are related to non-traumatic dental conditions.\u003c/p>\n\u003cp>In April, the American Dental Association released \u003ca href=\"http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_0415_2.ashx\" target=\"_blank\">a similar study\u003c/a> that drew similar conclusions.\u003c/p>\n\u003cp>\"One of the important things about the study we did is we looked at provider density,\" Raven said. \"People say there are plenty of dentists, but there's a subtler argument we're trying to make, that there is a low rate of dentists who take Medicaid.\"\u003c/p>\n\u003cp>Provider rates in California are among the lowest Medicaid rates in the nation, she said, but care can still be worked out in underserved urban areas, such as the use of mid-level dental providers -- or getting more dentists to see Medi-Cal patients.\u003c/p>\n\u003cp>\"It's too bad provider rates aren't higher,\" she said, \"but everyone needs to pitch in. Coverage is a necessity, but you have to pair it with providers.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>David Gorn is a senior reporter with \u003ca href=\"http://www.californiahealthline.org\" target=\"_blank\">California Healthline. \u003c/a>\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Researchers say while there are likely enough dentists, the problem is the low rate of those accepting Medicaid. ","status":"publish","parent":0,"modified":1438908691,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":16,"wordCount":461},"headData":{"title":"Even With Insurance, Medicaid Recipients Still Go to ER for Dental Problems | KQED","description":"Researchers say while there are likely enough dentists, the problem is the low rate of those accepting Medicaid. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Even With Insurance, Medicaid Recipients Still Go to ER for Dental Problems","datePublished":"2015-08-06T17:01:54.000Z","dateModified":"2015-08-07T00:51:31.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"57722 http://ww2.kqed.org/stateofhealth/?p=57722","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/08/06/even-with-insurance-medicaid-recipients-still-go-to-er-for-dental-problems/","disqusTitle":"Even With Insurance, Medicaid Recipients Still Go to ER for Dental Problems","nprByline":"David Gorn","path":"/stateofhealth/57722/even-with-insurance-medicaid-recipients-still-go-to-er-for-dental-problems","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>States that provide Medicaid adult dental care still have high rates of dental patients who show up at hospital emergency departments, particularly in urban underserved areas, according to a \u003ca href=\"https://med.stanford.edu/news/all-news/2015/08/medicaid-dental-coverage-may-not-prevent-tooth-related-er-visits.html\" target=\"_blank\">study released this week\u003c/a>. The study -- by researchers at Stanford University, UC San Francisco, Truven Health Analytics and the federal Agency for Healthcare Research and Quality -- was published in \u003cem>\u003ca href=\"http://content.healthaffairs.org/content/34/8/1349.abstract?=right\" target=\"_blank\">Health Affairs\u003c/a>\u003c/em>.\u003c/p>\n\u003caside class=\"pullquote alignright\">“People say there are plenty of dentists, but there’s a subtler argument we’re trying to make: that there is a low rate of dentists who take Medicaid.”\u003c/aside>\n\u003cp>Researchers said a dearth of dental providers who accept Medicaid patients, particularly in those urban underserved areas, has limited the effectiveness of Medicaid dental coverage in states that provide it.\u003c/p>\n\u003cp>\"We found that, in urban counties there were large concentrations of all providers, but not really to serve the poor,\" said Maria Raven, senior author of the study and associate professor of emergency medicine at UCSF.\u003c/p>\n\u003cp>\"There may be a higher density of dentists [in urban areas], but they're still not accepting Medi-Cal patients,\" Raven said. \"Coverage doesn't equal access.\"\u003c/p>\n\u003cp>That has resulted in high ED use even in states with Medicaid dental coverage, she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Medi-Cal is California's Medicaid program, and it did not have adult dental coverage in 2010, when the study's data were collected.\u003c/p>\n\u003cp>Katie Fingar, lead author of the study and research leader in health care at Truven, said the numbers were slightly better in rural areas.\u003c/p>\n\u003cp>\"We did see that for those in rural areas, a greater supply [of dental providers] was associated with lower ED use,\" Fingar said. But, she said, 90 percent of Medicaid dental visits are in urban areas.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>As a result, she said, more than 2 percent of all emergency department visits are related to non-traumatic dental conditions.\u003c/p>\n\u003cp>In April, the American Dental Association released \u003ca href=\"http://www.ada.org/~/media/ADA/Science%20and%20Research/HPI/Files/HPIBrief_0415_2.ashx\" target=\"_blank\">a similar study\u003c/a> that drew similar conclusions.\u003c/p>\n\u003cp>\"One of the important things about the study we did is we looked at provider density,\" Raven said. \"People say there are plenty of dentists, but there's a subtler argument we're trying to make, that there is a low rate of dentists who take Medicaid.\"\u003c/p>\n\u003cp>Provider rates in California are among the lowest Medicaid rates in the nation, she said, but care can still be worked out in underserved urban areas, such as the use of mid-level dental providers -- or getting more dentists to see Medi-Cal patients.\u003c/p>\n\u003cp>\"It's too bad provider rates aren't higher,\" she said, \"but everyone needs to pitch in. Coverage is a necessity, but you have to pair it with providers.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>David Gorn is a senior reporter with \u003ca href=\"http://www.californiahealthline.org\" target=\"_blank\">California Healthline. \u003c/a>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/57722/even-with-insurance-medicaid-recipients-still-go-to-er-for-dental-problems","authors":["byline_stateofhealth_57722"],"categories":["stateofhealth_11"],"tags":["stateofhealth_380","stateofhealth_99","stateofhealth_218"],"featImg":"stateofhealth_57727","label":"stateofhealth"},"stateofhealth_25334":{"type":"posts","id":"stateofhealth_25334","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"25334","score":null,"sort":[1431013780000]},"guestAuthors":[],"slug":"millions-struggle-to-access-dental-care-in-california","title":"State Expands Dental Coverage for Poor — But Getting Treatment Is Another Matter","publishDate":1431013780,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Inside the cavernous main building at the Sacramento County Fairgrounds was a beehive of activity. But this was no county fair or concert.\u003c/p>\n\u003cp>Instead, hundreds of long, reclining dental chairs fill the floor, and 2,000 people wait for a turn. The sound of drilling buzzed the air, and the acrid smell of anesthetic permeated it.\u003c/p>\n\u003cp>It was free dental day – a special program run by the California Dental Association Foundation. \"CDA Cares\" took over the entire fairgrounds for this event in March, and 300 dentists were busy pumping in Novocain and making lame jokes to captive patients.\u003c/p>\n\u003cp>Across the broad hall, there was one station for filling cavities, one for root canals, another for extractions, yet another for dentures.\u003c/p>\n\u003cp>It looked like a sort of Dental Disneyland.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Rhonda Morse of Sacramento was among the patients. She camped out at the fairgrounds the night before the event.\u003c/p>\n\u003cp>\"Got here at 7 o'clock last night,\" she said. \"We slept outside. It gets crowded real fast.\"\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/204359777\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>That's because the need is so profound. Denti-Cal, the state's program of dental care for low-income Californians, including 5 million children, is in disarray. At a time when millions more have been added into coverage, it’s becoming harder to find dental care. The CDA Foundation \u003ca title=\"http://www.cdafoundation.org/cda-cares\" href=\"http://www.cdafoundation.org/cda-cares\" target=\"_blank\">estimates that 10 million Californians\u003c/a> face barriers to dental care.\u003c/p>\n\u003cp>Morse knows this first-hand.\u003c/p>\n\u003cp>\"It takes months to get in, then you get an appointment, and it takes months to get in again,\" she explained.\u003c/p>\n\u003cp>She said it would have taken her years of appointments to get the dental care she received in a single day at the fair.\u003c/p>\n\u003cp>\"Coverage and access are two different things,\" said James Stephens, a Palo Alto dentist and former chair of the California Dental Association who volunteered for the Sacramento event.\u003c/p>\n\u003cp>The reason there's no access, he said, is because so few dentists take Denti-Cal patients -- because they lose money on every one of them.\u003c/p>\n\u003cp>\"Fees have been cut in the program so much, they're not enough to create a viable provider network,\" Stephens said.\u003c/p>\n\u003cfigure id=\"attachment_25339\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/IMG_1429-2-e1430955574138.jpg\">\u003cimg class=\"size-medium wp-image-25339\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/IMG_1429-2-800x1067.jpg\" alt=\"George Maranon, an oral surgeon from Encino, is extracting a tooth from a young boy who already has diseased gums. \" width=\"800\" height=\"1067\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">George Maranon, an oral surgeon from Encino, is extracting a tooth from a young boy who already has diseased gums. \u003ccite>(David Gorn/California Healthline)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>That network of providers is even thinner now, he said. So there are fewere dentists to serve even more people who have signed up since the state expanded eligibility rules.\u003c/p>\n\u003cp>George Maranon, an oral surgeon from Encino, was working on a tooth extraction at one of the fair stations for a 9-year-old boy with diseased gums. He said he'd rather volunteer his time than take Denti-Cal payments.\u003c/p>\n\u003cp>\"There are Denti-Cal patients who I actually see in my practice for free,\" Maranon said. \"Sometimes dealing with the state in terms of reimbursement can be more expensive than just doing it for free.\"\u003c/p>\n\u003cp>Just to get to the national average for provider rates, California would have to spend three times as much as it does now, at least another $100 million a year, according to Elizabeth Mertz, a dental sciences professor at UC San Francisco.\u003c/p>\n\u003cp>Beyond inadequate provider rates, there’s another huge challenge in the Denti-Cal system, Mertz said. Half of the state's kids are in Denti-Cal, and those kids desperately need preventive care.\u003c/p>\n\u003cp>\"So you're talking about taking care of a large portion of the state's children,\" she said. \"If those children grow up with dental disease, they're going to be adults with dental disease.\"\u003c/p>\n\u003cp>She said lawmakers could pass a dental health parity law, and that would put preventive dental health services on the same plane as other essential medical care.\u003c/p>\n\u003cp>\"Because nobody's made it a priority from the top on down,\" Mertz said. \"When you say something's essential but you make it optional, that's not sending the message that it's a priority.\"\u003c/p>\n\u003cp>The new director of the Department of Health Care Services, Jennifer Kent, has acknowledged the deficiencies of Denti-Cal and says fixing it is one of her top two priorities. The department is working on a plan now to restructure the program, but state officials haven't said whether or not that would include a boost in reimbursement rates.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In the meantime, \u003ca title=\"Fresno Dental Fair\" href=\"http://www.cdafoundation.org/cda-cares/fresno\" target=\"_blank\">the next free California Dental Association dental fair \u003c/a>will be held in Fresno, in October.\u003c/p>\n\n","blocks":[],"excerpt":"Many are covered by Denti-Cal, but reimbursements are so low that few dentists accept the patients. ","status":"publish","parent":0,"modified":1431020932,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":27,"wordCount":767},"headData":{"title":"State Expands Dental Coverage for Poor — But Getting Treatment Is Another Matter | KQED","description":"Many are covered by Denti-Cal, but reimbursements are so low that few dentists accept the patients. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"State Expands Dental Coverage for Poor — But Getting Treatment Is Another Matter","datePublished":"2015-05-07T15:49:40.000Z","dateModified":"2015-05-07T17:48:52.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"25334 http://ww2.kqed.org/stateofhealth/?p=25334","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/05/07/millions-struggle-to-access-dental-care-in-california/","disqusTitle":"State Expands Dental Coverage for Poor — But Getting Treatment Is Another Matter","nprByline":"David Gorn, California Healthline","path":"/stateofhealth/25334/millions-struggle-to-access-dental-care-in-california","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Inside the cavernous main building at the Sacramento County Fairgrounds was a beehive of activity. But this was no county fair or concert.\u003c/p>\n\u003cp>Instead, hundreds of long, reclining dental chairs fill the floor, and 2,000 people wait for a turn. The sound of drilling buzzed the air, and the acrid smell of anesthetic permeated it.\u003c/p>\n\u003cp>It was free dental day – a special program run by the California Dental Association Foundation. \"CDA Cares\" took over the entire fairgrounds for this event in March, and 300 dentists were busy pumping in Novocain and making lame jokes to captive patients.\u003c/p>\n\u003cp>Across the broad hall, there was one station for filling cavities, one for root canals, another for extractions, yet another for dentures.\u003c/p>\n\u003cp>It looked like a sort of Dental Disneyland.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Rhonda Morse of Sacramento was among the patients. She camped out at the fairgrounds the night before the event.\u003c/p>\n\u003cp>\"Got here at 7 o'clock last night,\" she said. \"We slept outside. It gets crowded real fast.\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/204359777&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/204359777'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>That's because the need is so profound. Denti-Cal, the state's program of dental care for low-income Californians, including 5 million children, is in disarray. At a time when millions more have been added into coverage, it’s becoming harder to find dental care. The CDA Foundation \u003ca title=\"http://www.cdafoundation.org/cda-cares\" href=\"http://www.cdafoundation.org/cda-cares\" target=\"_blank\">estimates that 10 million Californians\u003c/a> face barriers to dental care.\u003c/p>\n\u003cp>Morse knows this first-hand.\u003c/p>\n\u003cp>\"It takes months to get in, then you get an appointment, and it takes months to get in again,\" she explained.\u003c/p>\n\u003cp>She said it would have taken her years of appointments to get the dental care she received in a single day at the fair.\u003c/p>\n\u003cp>\"Coverage and access are two different things,\" said James Stephens, a Palo Alto dentist and former chair of the California Dental Association who volunteered for the Sacramento event.\u003c/p>\n\u003cp>The reason there's no access, he said, is because so few dentists take Denti-Cal patients -- because they lose money on every one of them.\u003c/p>\n\u003cp>\"Fees have been cut in the program so much, they're not enough to create a viable provider network,\" Stephens said.\u003c/p>\n\u003cfigure id=\"attachment_25339\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/IMG_1429-2-e1430955574138.jpg\">\u003cimg class=\"size-medium wp-image-25339\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/05/IMG_1429-2-800x1067.jpg\" alt=\"George Maranon, an oral surgeon from Encino, is extracting a tooth from a young boy who already has diseased gums. \" width=\"800\" height=\"1067\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">George Maranon, an oral surgeon from Encino, is extracting a tooth from a young boy who already has diseased gums. \u003ccite>(David Gorn/California Healthline)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>That network of providers is even thinner now, he said. So there are fewere dentists to serve even more people who have signed up since the state expanded eligibility rules.\u003c/p>\n\u003cp>George Maranon, an oral surgeon from Encino, was working on a tooth extraction at one of the fair stations for a 9-year-old boy with diseased gums. He said he'd rather volunteer his time than take Denti-Cal payments.\u003c/p>\n\u003cp>\"There are Denti-Cal patients who I actually see in my practice for free,\" Maranon said. \"Sometimes dealing with the state in terms of reimbursement can be more expensive than just doing it for free.\"\u003c/p>\n\u003cp>Just to get to the national average for provider rates, California would have to spend three times as much as it does now, at least another $100 million a year, according to Elizabeth Mertz, a dental sciences professor at UC San Francisco.\u003c/p>\n\u003cp>Beyond inadequate provider rates, there’s another huge challenge in the Denti-Cal system, Mertz said. Half of the state's kids are in Denti-Cal, and those kids desperately need preventive care.\u003c/p>\n\u003cp>\"So you're talking about taking care of a large portion of the state's children,\" she said. \"If those children grow up with dental disease, they're going to be adults with dental disease.\"\u003c/p>\n\u003cp>She said lawmakers could pass a dental health parity law, and that would put preventive dental health services on the same plane as other essential medical care.\u003c/p>\n\u003cp>\"Because nobody's made it a priority from the top on down,\" Mertz said. \"When you say something's essential but you make it optional, that's not sending the message that it's a priority.\"\u003c/p>\n\u003cp>The new director of the Department of Health Care Services, Jennifer Kent, has acknowledged the deficiencies of Denti-Cal and says fixing it is one of her top two priorities. The department is working on a plan now to restructure the program, but state officials haven't said whether or not that would include a boost in reimbursement rates.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In the meantime, \u003ca title=\"Fresno Dental Fair\" href=\"http://www.cdafoundation.org/cda-cares/fresno\" target=\"_blank\">the next free California Dental Association dental fair \u003c/a>will be held in Fresno, in October.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/25334/millions-struggle-to-access-dental-care-in-california","authors":["byline_stateofhealth_25334"],"categories":["stateofhealth_11","stateofhealth_13"],"tags":["stateofhealth_380"],"featImg":"stateofhealth_25338","label":"stateofhealth"},"stateofhealth_15935":{"type":"posts","id":"stateofhealth_15935","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"15935","score":null,"sort":[1383238186000]},"guestAuthors":[],"slug":"website-brings-discounts-cost-transparency-to-dental-care","title":"Website Brings Discounts, Cost Transparency to Dental Care ","publishDate":1383238186,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_15967\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/pepino1976/7619706126/sizes/l/in/photolist-cBjZay-ducrMh-dKTpPK-dKYUzQ-diM3uy-7JLnkS-7JGnFv-8hdW7r-8MTQVj-cuEzCL-cN2XHC-dpvLuP-eaQAZQ-buYDgX-8sSw5d-bfeYQ2-dQnMS9-85JHLn-eQqNd7-8DU6Hm-9c86w9-892GLD-8ZGa1U-dkBvEb-aTEqSR/\">\u003cimg class=\"size-full wp-image-15967\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/7619706126_5ac8fab2a7_z.jpg\" alt=\"(Pepino1976/Flickr)\" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/7619706126_5ac8fab2a7_z.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/7619706126_5ac8fab2a7_z-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/7619706126_5ac8fab2a7_z-320x240.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Pepino1976/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Like health care, dental care matters, too. While about 14 percent of Californians lack health insurance, 39 percent \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/D/PDF%20DentalInsuranceInCalifornia.pdf\" target=\"_blank\">lack dental coverage\u003c/a>, according to a 2009 brief from the California HealthCare Foundation.\u003c/p>\n\u003cp>Even if you have dental insurance, it often has coverage limits and varying levels of out-of-pocket spending requirements that differ from health insurance, as a recent Los Angeles Times report\u003ca href=\"http://articles.latimes.com/2013/aug/30/business/la-fi-healthcare-watch-20130901\" target=\"_blank\"> noted\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>First, it's specifically designed to encourage preventive treatment. That's why most dental plans pay 100 percent for preventive services, such as cleanings, X-rays and checkups. Basic restorative services such as fillings and periodontal cleanings are generally covered at 80 percent, and you'll commonly get just 50 percent reimbursement for procedures such as implants and crowns.\u003c/p>\n\u003cp>In addition, they commonly come with low annual maximums that place a cap on what the plan pays toward care — the typical range is $1,000 to $1,500.\u003c/p>\n\u003cp>Even with coverage, the high cost of dental procedures prevents many people from seeking care. In a recent study of Los Angeles residents conducted by Empirica Research, 51 percent with dental insurance say they've delayed care because of cost. That number jumps to 68 percent among those without coverage.\u003c/p>\u003c/blockquote>\n\u003cp>Now, a new website,\u003ca href=\"https://www.brighter.com\" target=\"_blank\"> Brighter.com\u003c/a>, has launched a free (to consumers) service to help connect people with dentists — at a discount. \"The mission was to provide quality, affordable care to everyone,\" said Jake Winebaum, Brighter's CEO. \"Brighter is the first marketplace where dentists are competing for patients based on quality, price and convenience.\"\u003c!--more-->\u003c/p>\n\u003cp>Brighter has recruited a network of some 600 dentists. The individual dentists set their own prices for procedures, and all pricing is transparent on the website. Consumers can search for a dentist any way they like — by geography or by price — and book an appointment online. Patients must pay in full at the time of service.\u003c/p>\n\u003cp>Kate Quirk of Agoura Hills says she and her husband decided to opt out of the dental insurance offered by his employer. She says since they're young and healthy, they decided to pay out-of-pocket for preventive care. She found the website \"straightforward, easy to use\" and that the discounts offered are \"pretty steep, almost unreal.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>She said she was skeptical about the quality of Brighter's dentists but checked the ratings listed, including links to Yelp ratings on Brighter's site. She's been very happy with the dentist she chose, Michael Wong, in Santa Monica. His published \"checkup and cleaning\" price is $350, but he offers it for $150 on Brighter. Other Santa Monica dentists charge less than $100 for a checkup and cleaning.\u003c/p>\n\u003cp>Dentists pay $50 for each patient who comes in for an appointment. Dr. Wong said he's seeing about 4 to 6 patients a month from Brighter. He says he's \"interested in doing high-quality dentistry,\" and that he does little other marketing besides Brighter. Most of his practice is word of mouth, and he hopes Brighter may add to that. \"I get a patient in, if they like their treatment, they send friends and family.\"\u003c/p>\n\u003cp>Dr. Goli Javaher, also a dentist in Santa Monica, likes the lack of paperwork. She also observed that it's not fair that uninsured patients pay higher prices than patients with insurance, who benefit from the bargaining power of the insurance company. \"The patients are so grateful,\" she said. It's treating them at the \"same price as insurance.\"\u003c/p>\n\u003cp>Quirk said she started seeing Dr. Wong when she lived closer to Santa Monica than she does now. But she liked him so much she says she may make the drive to continue to see him.\u003c/p>\n\u003cp>\"You've got really happy patients who are getting something they couldn't get before,\" Winebaum said, referring again to what he calls quality, affordable care, \"and really happy dentists who are getting loyal patients.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Brighter is beginning an expansion in southern California outside of Los Angeles. In 2014 the company will expand to other not-yet-announced metropolitan areas outside California.\u003c/p>\n\n","blocks":[],"excerpt":"Like health care, dental care matters, too. While about 14 percent of Californians lack health insurance, 39 percent lack dental coverage, according to a 2009 brief from the California HealthCare Foundation.\r\n\r\nEven if you have dental insurance, it often has coverage limits and varying levels of out-of-pocket spending requirements that differ from health insurance","status":"publish","parent":0,"modified":1383318359,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":16,"wordCount":684},"headData":{"title":"Website Brings Discounts, Cost Transparency to Dental Care | KQED","description":"Like health care, dental care matters, too. While about 14 percent of Californians lack health insurance, 39 percent lack dental coverage, according to a 2009 brief from the California HealthCare Foundation.\r\n\r\nEven if you have dental insurance, it often has coverage limits and varying levels of out-of-pocket spending requirements that differ from health insurance","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Website Brings Discounts, Cost Transparency to Dental Care ","datePublished":"2013-10-31T16:49:46.000Z","dateModified":"2013-11-01T15:05:59.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"15935 http://blogs.kqed.org/stateofhealth/?p=15935","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/10/31/website-brings-discounts-cost-transparency-to-dental-care/","disqusTitle":"Website Brings Discounts, Cost Transparency to Dental Care ","path":"/stateofhealth/15935/website-brings-discounts-cost-transparency-to-dental-care","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15967\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://www.flickr.com/photos/pepino1976/7619706126/sizes/l/in/photolist-cBjZay-ducrMh-dKTpPK-dKYUzQ-diM3uy-7JLnkS-7JGnFv-8hdW7r-8MTQVj-cuEzCL-cN2XHC-dpvLuP-eaQAZQ-buYDgX-8sSw5d-bfeYQ2-dQnMS9-85JHLn-eQqNd7-8DU6Hm-9c86w9-892GLD-8ZGa1U-dkBvEb-aTEqSR/\">\u003cimg class=\"size-full wp-image-15967\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/7619706126_5ac8fab2a7_z.jpg\" alt=\"(Pepino1976/Flickr)\" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/10/7619706126_5ac8fab2a7_z.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/7619706126_5ac8fab2a7_z-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/10/7619706126_5ac8fab2a7_z-320x240.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Pepino1976/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Like health care, dental care matters, too. While about 14 percent of Californians lack health insurance, 39 percent \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/D/PDF%20DentalInsuranceInCalifornia.pdf\" target=\"_blank\">lack dental coverage\u003c/a>, according to a 2009 brief from the California HealthCare Foundation.\u003c/p>\n\u003cp>Even if you have dental insurance, it often has coverage limits and varying levels of out-of-pocket spending requirements that differ from health insurance, as a recent Los Angeles Times report\u003ca href=\"http://articles.latimes.com/2013/aug/30/business/la-fi-healthcare-watch-20130901\" target=\"_blank\"> noted\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>First, it's specifically designed to encourage preventive treatment. That's why most dental plans pay 100 percent for preventive services, such as cleanings, X-rays and checkups. Basic restorative services such as fillings and periodontal cleanings are generally covered at 80 percent, and you'll commonly get just 50 percent reimbursement for procedures such as implants and crowns.\u003c/p>\n\u003cp>In addition, they commonly come with low annual maximums that place a cap on what the plan pays toward care — the typical range is $1,000 to $1,500.\u003c/p>\n\u003cp>Even with coverage, the high cost of dental procedures prevents many people from seeking care. In a recent study of Los Angeles residents conducted by Empirica Research, 51 percent with dental insurance say they've delayed care because of cost. That number jumps to 68 percent among those without coverage.\u003c/p>\u003c/blockquote>\n\u003cp>Now, a new website,\u003ca href=\"https://www.brighter.com\" target=\"_blank\"> Brighter.com\u003c/a>, has launched a free (to consumers) service to help connect people with dentists — at a discount. \"The mission was to provide quality, affordable care to everyone,\" said Jake Winebaum, Brighter's CEO. \"Brighter is the first marketplace where dentists are competing for patients based on quality, price and convenience.\"\u003c!--more-->\u003c/p>\n\u003cp>Brighter has recruited a network of some 600 dentists. The individual dentists set their own prices for procedures, and all pricing is transparent on the website. Consumers can search for a dentist any way they like — by geography or by price — and book an appointment online. Patients must pay in full at the time of service.\u003c/p>\n\u003cp>Kate Quirk of Agoura Hills says she and her husband decided to opt out of the dental insurance offered by his employer. She says since they're young and healthy, they decided to pay out-of-pocket for preventive care. She found the website \"straightforward, easy to use\" and that the discounts offered are \"pretty steep, almost unreal.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>She said she was skeptical about the quality of Brighter's dentists but checked the ratings listed, including links to Yelp ratings on Brighter's site. She's been very happy with the dentist she chose, Michael Wong, in Santa Monica. His published \"checkup and cleaning\" price is $350, but he offers it for $150 on Brighter. Other Santa Monica dentists charge less than $100 for a checkup and cleaning.\u003c/p>\n\u003cp>Dentists pay $50 for each patient who comes in for an appointment. Dr. Wong said he's seeing about 4 to 6 patients a month from Brighter. He says he's \"interested in doing high-quality dentistry,\" and that he does little other marketing besides Brighter. Most of his practice is word of mouth, and he hopes Brighter may add to that. \"I get a patient in, if they like their treatment, they send friends and family.\"\u003c/p>\n\u003cp>Dr. Goli Javaher, also a dentist in Santa Monica, likes the lack of paperwork. She also observed that it's not fair that uninsured patients pay higher prices than patients with insurance, who benefit from the bargaining power of the insurance company. \"The patients are so grateful,\" she said. It's treating them at the \"same price as insurance.\"\u003c/p>\n\u003cp>Quirk said she started seeing Dr. Wong when she lived closer to Santa Monica than she does now. But she liked him so much she says she may make the drive to continue to see him.\u003c/p>\n\u003cp>\"You've got really happy patients who are getting something they couldn't get before,\" Winebaum said, referring again to what he calls quality, affordable care, \"and really happy dentists who are getting loyal patients.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Brighter is beginning an expansion in southern California outside of Los Angeles. In 2014 the company will expand to other not-yet-announced metropolitan areas outside California.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/15935/website-brings-discounts-cost-transparency-to-dental-care","authors":["240"],"categories":["stateofhealth_12"],"tags":["stateofhealth_380"],"featImg":"stateofhealth_15967","label":"stateofhealth"},"stateofhealth_9498":{"type":"posts","id":"stateofhealth_9498","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"9498","score":null,"sort":[1355524236000]},"guestAuthors":[],"slug":"california-prepares-for-childrens-dental-insurance-mandate","title":"California Prepares for Children's Dental Insurance Mandate","publishDate":1355524236,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>\u003cem>By Laird Harrison\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_6734\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/Child-at-dentist.jpg\">\u003cimg class=\"size-medium wp-image-6734 \" title=\"More people may get dental care in Calfornia when the Affordable Care Act is implemented. (heraldpost/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/Child-at-dentist-300x271.jpg\" alt=\"More people may get dental care in Calfornia when the Affordable Care Act is implemented. (heraldpost/Flickr)\" width=\"300\" height=\"271\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">More people may get dental care in Calfornia when the Affordable Care Act is implemented. (heraldpost/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>If you know anything about the Affordable Care Act -- otherwise known as Obamacare -- you know that it will require everyone to get medical coverage by January 1, 2014.\u003c/p>\n\u003cp>But did you know that the act could also require millions of families to buy dental benefits for their children?\u003c/p>\n\u003cp>The dental mandate, if you want to call it that, is indirect and incomplete. Parents who are determined to avoid it can find loopholes. And much depends on regulations that state and federal authorities are still hashing out.\u003c/p>\n\u003cp>But preliminary estimates show that some five million children nationwide and as many as 1.5 million Californians could gain extensive new dental benefits.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Starting in 2014, the Affordable Care Act says, all medical plans sold to small groups (100 people or fewer) or individuals must include a set of “essential benefits,” and these benefits must include “pediatric services, including oral and vision care.”\u003c/p>\n\u003cp>In California, the benefits will be pretty extensive. The state has decided to base them on its \u003ca href=\"http://www.healthyfamilies.ca.gov/HFProgram/Summary_of_Benefits.aspx#dental\">Healthy Families dental program\u003c/a>.\u003c!--more-->\u003c/p>\n\u003cp>Here is where the law gets tricky. The law says that dental plans and medical plans can be sold separately. While the Affordable Care Act imposes a penalty on people who don’t have medical insurance, it does \u003cem>not\u003c/em> say what happens if someone doesn’t get dental coverage for their kids.\u003c/p>\n\u003cp>I called the U.S. Health and Human Services Department, which has so far remained silent on that question. A spokesperson said told me no one would be available for an interview, and instead issued this statement: \"The department will issue further guidance on essential health benefits through the rulemaking process.\" (They've been issuing \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/12/10/feds-to-states-on-medicaid-expand-fully-or-no-new-funding/\" target=\"_blank\">a lot of guidance\u003c/a> lately, just not on this issue.)\u003c/p>\n\u003cp>Evelyn Ireland, executive director of the National Association of Dental Plans says that federal regulators have told her the question may be left up to individual states. I then called the California Health Benefit Exchange, but was told that no one would be available to comment until next week.\u003c/p>\n\u003cp>Even if most parents do sign up for the coverage, the NADP is warning of another potential problem. It says new fees charged to insurers -- along with the cost of expanding the benefits -- will make children’s dental plans more expensive than what is currently on the market for small groups and individuals. Instead of about $21 per child per month, the cost could go up to $28 or even $36, depending on copayments, the organization says.\u003c/p>\n\u003cp>If you’re below 400 percent of the federal poverty level ($92,000 for a family of four) and spend more than 9.5 percent of your income on health insurance, the Affordable Care Act provides a \u003ca href=\"http://www.kff.org/healthreform/upload/7962-02.pdf\">subsidy\u003c/a> to help you pay for these benefits. But even so, the NADP estimates that nationwide as many as 11 million adults who have dental benefits will decide they can’t afford benefits for both themselves and their kids, and will drop their own benefits. “The entire landscape is changing,” says Jeff Album, vice president of public and government affairs for Delta California.\u003c/p>\n\u003cp>Not everyone agrees with that prediction. The California Dental Association is confident that the new exchange will keep dental benefit costs under control. CDA President Lindsey Robinson praised California's choice to use the extensive dental benefits in the Healthy Families program. “It has a proven track record of meeting the oral health needs of California standards and meets the professional standards of dentists who are taking care of children,” she said.\u003c/p>\n\u003cp>Robinson is also hopeful that the state has enough dentists to cover all the children who might gain benefits under the new law.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>All that remains to be seen is how many parents will sign up.\u003c/p>\n\n","blocks":[],"excerpt":"If you know anything about the Affordable Care Act -- otherwise known as Obamacare -- you know that it will require everyone to get medical coverage by January 1, 2014.","status":"publish","parent":0,"modified":1355536605,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":17,"wordCount":660},"headData":{"title":"California Prepares for Children's Dental Insurance Mandate | KQED","description":"If you know anything about the Affordable Care Act -- otherwise known as Obamacare -- you know that it will require everyone to get medical coverage by January 1, 2014.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"California Prepares for Children's Dental Insurance Mandate","datePublished":"2012-12-14T22:30:36.000Z","dateModified":"2012-12-15T01:56:45.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"9498 http://blogs.kqed.org/stateofhealth/?p=9498","disqusUrl":"https://ww2.kqed.org/stateofhealth/2012/12/14/california-prepares-for-childrens-dental-insurance-mandate/","disqusTitle":"California Prepares for Children's Dental Insurance Mandate","path":"/stateofhealth/9498/california-prepares-for-childrens-dental-insurance-mandate","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>By Laird Harrison\u003c/em>\u003c/p>\n\u003cfigure id=\"attachment_6734\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/Child-at-dentist.jpg\">\u003cimg class=\"size-medium wp-image-6734 \" title=\"More people may get dental care in Calfornia when the Affordable Care Act is implemented. (heraldpost/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/Child-at-dentist-300x271.jpg\" alt=\"More people may get dental care in Calfornia when the Affordable Care Act is implemented. (heraldpost/Flickr)\" width=\"300\" height=\"271\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">More people may get dental care in Calfornia when the Affordable Care Act is implemented. (heraldpost/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>If you know anything about the Affordable Care Act -- otherwise known as Obamacare -- you know that it will require everyone to get medical coverage by January 1, 2014.\u003c/p>\n\u003cp>But did you know that the act could also require millions of families to buy dental benefits for their children?\u003c/p>\n\u003cp>The dental mandate, if you want to call it that, is indirect and incomplete. Parents who are determined to avoid it can find loopholes. And much depends on regulations that state and federal authorities are still hashing out.\u003c/p>\n\u003cp>But preliminary estimates show that some five million children nationwide and as many as 1.5 million Californians could gain extensive new dental benefits.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Starting in 2014, the Affordable Care Act says, all medical plans sold to small groups (100 people or fewer) or individuals must include a set of “essential benefits,” and these benefits must include “pediatric services, including oral and vision care.”\u003c/p>\n\u003cp>In California, the benefits will be pretty extensive. The state has decided to base them on its \u003ca href=\"http://www.healthyfamilies.ca.gov/HFProgram/Summary_of_Benefits.aspx#dental\">Healthy Families dental program\u003c/a>.\u003c!--more-->\u003c/p>\n\u003cp>Here is where the law gets tricky. The law says that dental plans and medical plans can be sold separately. While the Affordable Care Act imposes a penalty on people who don’t have medical insurance, it does \u003cem>not\u003c/em> say what happens if someone doesn’t get dental coverage for their kids.\u003c/p>\n\u003cp>I called the U.S. Health and Human Services Department, which has so far remained silent on that question. A spokesperson said told me no one would be available for an interview, and instead issued this statement: \"The department will issue further guidance on essential health benefits through the rulemaking process.\" (They've been issuing \u003ca href=\"http://ww2.kqed.org/stateofhealth/2012/12/10/feds-to-states-on-medicaid-expand-fully-or-no-new-funding/\" target=\"_blank\">a lot of guidance\u003c/a> lately, just not on this issue.)\u003c/p>\n\u003cp>Evelyn Ireland, executive director of the National Association of Dental Plans says that federal regulators have told her the question may be left up to individual states. I then called the California Health Benefit Exchange, but was told that no one would be available to comment until next week.\u003c/p>\n\u003cp>Even if most parents do sign up for the coverage, the NADP is warning of another potential problem. It says new fees charged to insurers -- along with the cost of expanding the benefits -- will make children’s dental plans more expensive than what is currently on the market for small groups and individuals. Instead of about $21 per child per month, the cost could go up to $28 or even $36, depending on copayments, the organization says.\u003c/p>\n\u003cp>If you’re below 400 percent of the federal poverty level ($92,000 for a family of four) and spend more than 9.5 percent of your income on health insurance, the Affordable Care Act provides a \u003ca href=\"http://www.kff.org/healthreform/upload/7962-02.pdf\">subsidy\u003c/a> to help you pay for these benefits. But even so, the NADP estimates that nationwide as many as 11 million adults who have dental benefits will decide they can’t afford benefits for both themselves and their kids, and will drop their own benefits. “The entire landscape is changing,” says Jeff Album, vice president of public and government affairs for Delta California.\u003c/p>\n\u003cp>Not everyone agrees with that prediction. The California Dental Association is confident that the new exchange will keep dental benefit costs under control. CDA President Lindsey Robinson praised California's choice to use the extensive dental benefits in the Healthy Families program. “It has a proven track record of meeting the oral health needs of California standards and meets the professional standards of dentists who are taking care of children,” she said.\u003c/p>\n\u003cp>Robinson is also hopeful that the state has enough dentists to cover all the children who might gain benefits under the new law.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>All that remains to be seen is how many parents will sign up.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/9498/california-prepares-for-childrens-dental-insurance-mandate","authors":["240"],"categories":["stateofhealth_15","stateofhealth_14"],"tags":["stateofhealth_38","stateofhealth_380"],"featImg":"stateofhealth_6734","label":"stateofhealth"},"stateofhealth_9305":{"type":"posts","id":"stateofhealth_9305","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"9305","score":null,"sort":[1354906980000]},"guestAuthors":[],"slug":"how-many-dentists-accept-children-on-medi-cal-new-report-says-one-in-four","title":"How Many Dentists Accept Children on Medi-Cal? Depends on Who You Ask","publishDate":1354906980,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>\u003cstrong>New report says one in four dentists accept state's Denti-Cal insurance; older reports say closer to two-thirds\u003c/strong>\u003c/p>\n\u003cp>By Emily Bazar, \u003ca href=\"http://centerforhealthreporting.org/blog/how-many-california-dentists-accept-poor-kids-medi-cal-new-report-says-one-four1026\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_9308\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/KidAtDentist_PaulGoyette_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-9308\" title=\"(Paul Goyette/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/KidAtDentist_PaulGoyette_Flickr-300x200.jpg\" alt=\"(Paul Goyette/Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Paul Goyette/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>I’ve spent many months reporting on dental care for poor California children, looking into what kind of access they have to treatment.\u003c/p>\n\u003cp>(About half of kids in the Medi-Cal dental program see a dentist annually, although figures vary wildly by county.)\u003c/p>\n\u003cp>But I haven’t focused as much on the dentists who participate in the program, called Denti-Cal.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"http://centerforhealthreporting.org/sites/default/files/denti-cal_final_report_nov_2_2012.pdf\" target=\"_blank\">A new report\u003c/a> by \u003ca href=\"http://www.barbaraavedassociates.com/\" target=\"_blank\">health care consultant Barbara Aved\u003c/a> does just that. Based on her research, Aved concludes that 25 percent of California’s general dentists participate in the program.\u003c/p>\n\u003cp>Why not more? Here are some of Aved’s primary conclusions, based in part on a survey of dentists in five counties that she says reflect California as a whole. Out of about 2,000 general and pediatric dentists invited to participate, 322 responded.\u003c/p>\n\u003cul>\n\u003cul>\n\u003cli>Of dentists who do not participate, 97 percent cited the state’s low reimbursement rates as the No. 1 reason. California’s rates, Aved said, are among the lowest in the nation.\u003c/li>\n\u003c/ul>\n\u003c/ul>\n\u003cp>“Unlike physician practices, dental practices are in large part solo or two-person practices,” she said. “It’s really like a small business. Economically, it just doesn’t make sense to do business where you’re not going to be fully reimbursed.”\u003c!--more-->\u003c/p>\n\u003cul>\n\u003cli>Many dentists also blamed their non-participation on the bureaucratic requirements associated with enrolling and billing.\u003c/li>\n\u003c/ul>\n\u003cp>“Make the claim process simple and straightforward; quit denying claims for stupid, little reasons and obscure criteria,” wrote one dentist who responded to the survey.\u003c/p>\n\u003cp>“I would rather treat some people for nothing than jump through all the hoops Denti-Cal makes you go through,” wrote another.\u003c/p>\n\u003cul>\n\u003cli>Some dentists complained about patients breaking appointments and other compliance issues.\u003c/li>\n\u003c/ul>\n\u003cp>Aved’s study, which also analyzed 2011 Denti-Cal claims data, was commissioned by dental plans LIBERTY Dental and HealthNet.\u003c/p>\n\u003cp>The Department of Health Care Services (DHCS), which administers Denti-Cal, has a very different take on the percentage of California dentists who participate: Two thirds of dentists, or 66 percent.\u003c/p>\n\u003cp>“What we’ve done with our numbers is take a look at verifiable data, data that was collected and that represents the actual figures that are kept by the state of California,” said spokesman Norman Williams. “It wasn’t a survey. … It’s actual data and that’s what we base our numbers on.”\u003c/p>\n\u003cp>But Aved pointed to a \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/D/PDF%20DentiCalFactsAndFigures2010.pdf\" target=\"_blank\">California HealthCare Foundation report\u003c/a> on Denti-Cal from 2010 that also concluded that 25 percent of California dentists accept Medi-Cal patients.\u003c/p>\n\u003cp>Williams said current dentist participation in Denti-Cal already “ensures sufficient access,” but the department is taking several steps to boost participation. They include:\u003c/p>\n\u003cul>\n\u003cli>Developing a survey for Denti-Cal beneficiaries to determine their satisfaction with the program;\u003c/li>\n\u003cli>Offering a new customer service line to help children and their families locate participating dentists; and\u003c/li>\n\u003cli>Reaching out to dentists to urge them to join the program or take more Denti-Cal patients.\u003c/li>\n\u003c/ul>\n\u003cp>The department is addressing complaints about bureaucratic obstacles by developing a webinar series, video tutorials and other materials for dentists to help them with enrollment and billing, Williams said.\u003c/p>\n\u003cp>But raising rates isn’t on the table.\u003c/p>\n\u003cp>“Because of our current economic situation, the state is not in a financial position to increase Medi-Cal payments to dentists,” Williams said.\u003c/p>\n\u003cp>Gayle Mathe, director of policy development for the \u003ca href=\"http://www.cda.org/\" target=\"_blank\">California Dental Association\u003c/a>, applauded the department for its recent moves to boost dentist ranks in the program. In many cases, she said, her association is partnering on these initiatives.\u003c/p>\n\u003cp>“We’re starting to see movement and changes in a positive direction,” she said. “And the department is really engaged in doing that.”\u003c/p>\n\u003cp>But the association questions the department’s conclusion that two-thirds of dentists participate Denti-Cal, saying that Aved’s figure is closer.\u003c/p>\n\u003cp>“We don’t have access to data, but the 25 percent is consistent with what we’ve heard anecdotally over the years,” Mathe said.\u003c/p>\n\u003cp>Aved said she’s concerned that not enough dentists participate as it is and worries that Denti-Cal isn’t prepared for the hundreds of thousands of new children coming into the program in the next few years. This will be primarily as a result of the transition of children \u003ca href=\"http://www.dhcs.ca.gov/services/Pages/HealthyFamiliesTransition.aspx\" target=\"_blank\">from the publicly-funded Healthy Families program into Medi-Cal\u003c/a> and the expansion of Medi-Cal under the Affordable Care Act.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“If it’s this way now, we should be worried about the future for sure,” she said.\u003c/p>\n\n","blocks":[],"excerpt":"I’ve spent many months reporting on dental care for poor California children, looking into what kind of access they have to treatment.\r\n\r\n(About half of kids in the Medi-Cal dental program see a dentist annually, although figures vary wildly by county.)\r\n\r\nBut I haven’t focused as much on the dentists who participate in the program, called Denti-Cal.\r\n\r\nA new report by health care consultant Barbara Aved does just that. Based on her research, Aved concludes that 25 percent of California’s general dentists participate in the program.","status":"publish","parent":0,"modified":1354922739,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":26,"wordCount":830},"headData":{"title":"How Many Dentists Accept Children on Medi-Cal? Depends on Who You Ask | KQED","description":"I’ve spent many months reporting on dental care for poor California children, looking into what kind of access they have to treatment.\r\n\r\n(About half of kids in the Medi-Cal dental program see a dentist annually, although figures vary wildly by county.)\r\n\r\nBut I haven’t focused as much on the dentists who participate in the program, called Denti-Cal.\r\n\r\nA new report by health care consultant Barbara Aved does just that. Based on her research, Aved concludes that 25 percent of California’s general dentists participate in the program.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"How Many Dentists Accept Children on Medi-Cal? Depends on Who You Ask","datePublished":"2012-12-07T19:03:00.000Z","dateModified":"2012-12-07T23:25:39.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"9305 http://blogs.kqed.org/stateofhealth/?p=9305","disqusUrl":"https://ww2.kqed.org/stateofhealth/2012/12/07/how-many-dentists-accept-children-on-medi-cal-new-report-says-one-in-four/","disqusTitle":"How Many Dentists Accept Children on Medi-Cal? Depends on Who You Ask","path":"/stateofhealth/9305/how-many-dentists-accept-children-on-medi-cal-new-report-says-one-in-four","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>New report says one in four dentists accept state's Denti-Cal insurance; older reports say closer to two-thirds\u003c/strong>\u003c/p>\n\u003cp>By Emily Bazar, \u003ca href=\"http://centerforhealthreporting.org/blog/how-many-california-dentists-accept-poor-kids-medi-cal-new-report-says-one-four1026\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_9308\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/KidAtDentist_PaulGoyette_Flickr.jpg\">\u003cimg class=\"size-medium wp-image-9308\" title=\"(Paul Goyette/Flickr)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/12/KidAtDentist_PaulGoyette_Flickr-300x200.jpg\" alt=\"(Paul Goyette/Flickr)\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Paul Goyette/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>I’ve spent many months reporting on dental care for poor California children, looking into what kind of access they have to treatment.\u003c/p>\n\u003cp>(About half of kids in the Medi-Cal dental program see a dentist annually, although figures vary wildly by county.)\u003c/p>\n\u003cp>But I haven’t focused as much on the dentists who participate in the program, called Denti-Cal.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://centerforhealthreporting.org/sites/default/files/denti-cal_final_report_nov_2_2012.pdf\" target=\"_blank\">A new report\u003c/a> by \u003ca href=\"http://www.barbaraavedassociates.com/\" target=\"_blank\">health care consultant Barbara Aved\u003c/a> does just that. Based on her research, Aved concludes that 25 percent of California’s general dentists participate in the program.\u003c/p>\n\u003cp>Why not more? Here are some of Aved’s primary conclusions, based in part on a survey of dentists in five counties that she says reflect California as a whole. Out of about 2,000 general and pediatric dentists invited to participate, 322 responded.\u003c/p>\n\u003cul>\n\u003cul>\n\u003cli>Of dentists who do not participate, 97 percent cited the state’s low reimbursement rates as the No. 1 reason. California’s rates, Aved said, are among the lowest in the nation.\u003c/li>\n\u003c/ul>\n\u003c/ul>\n\u003cp>“Unlike physician practices, dental practices are in large part solo or two-person practices,” she said. “It’s really like a small business. Economically, it just doesn’t make sense to do business where you’re not going to be fully reimbursed.”\u003c!--more-->\u003c/p>\n\u003cul>\n\u003cli>Many dentists also blamed their non-participation on the bureaucratic requirements associated with enrolling and billing.\u003c/li>\n\u003c/ul>\n\u003cp>“Make the claim process simple and straightforward; quit denying claims for stupid, little reasons and obscure criteria,” wrote one dentist who responded to the survey.\u003c/p>\n\u003cp>“I would rather treat some people for nothing than jump through all the hoops Denti-Cal makes you go through,” wrote another.\u003c/p>\n\u003cul>\n\u003cli>Some dentists complained about patients breaking appointments and other compliance issues.\u003c/li>\n\u003c/ul>\n\u003cp>Aved’s study, which also analyzed 2011 Denti-Cal claims data, was commissioned by dental plans LIBERTY Dental and HealthNet.\u003c/p>\n\u003cp>The Department of Health Care Services (DHCS), which administers Denti-Cal, has a very different take on the percentage of California dentists who participate: Two thirds of dentists, or 66 percent.\u003c/p>\n\u003cp>“What we’ve done with our numbers is take a look at verifiable data, data that was collected and that represents the actual figures that are kept by the state of California,” said spokesman Norman Williams. “It wasn’t a survey. … It’s actual data and that’s what we base our numbers on.”\u003c/p>\n\u003cp>But Aved pointed to a \u003ca href=\"http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/D/PDF%20DentiCalFactsAndFigures2010.pdf\" target=\"_blank\">California HealthCare Foundation report\u003c/a> on Denti-Cal from 2010 that also concluded that 25 percent of California dentists accept Medi-Cal patients.\u003c/p>\n\u003cp>Williams said current dentist participation in Denti-Cal already “ensures sufficient access,” but the department is taking several steps to boost participation. They include:\u003c/p>\n\u003cul>\n\u003cli>Developing a survey for Denti-Cal beneficiaries to determine their satisfaction with the program;\u003c/li>\n\u003cli>Offering a new customer service line to help children and their families locate participating dentists; and\u003c/li>\n\u003cli>Reaching out to dentists to urge them to join the program or take more Denti-Cal patients.\u003c/li>\n\u003c/ul>\n\u003cp>The department is addressing complaints about bureaucratic obstacles by developing a webinar series, video tutorials and other materials for dentists to help them with enrollment and billing, Williams said.\u003c/p>\n\u003cp>But raising rates isn’t on the table.\u003c/p>\n\u003cp>“Because of our current economic situation, the state is not in a financial position to increase Medi-Cal payments to dentists,” Williams said.\u003c/p>\n\u003cp>Gayle Mathe, director of policy development for the \u003ca href=\"http://www.cda.org/\" target=\"_blank\">California Dental Association\u003c/a>, applauded the department for its recent moves to boost dentist ranks in the program. In many cases, she said, her association is partnering on these initiatives.\u003c/p>\n\u003cp>“We’re starting to see movement and changes in a positive direction,” she said. “And the department is really engaged in doing that.”\u003c/p>\n\u003cp>But the association questions the department’s conclusion that two-thirds of dentists participate Denti-Cal, saying that Aved’s figure is closer.\u003c/p>\n\u003cp>“We don’t have access to data, but the 25 percent is consistent with what we’ve heard anecdotally over the years,” Mathe said.\u003c/p>\n\u003cp>Aved said she’s concerned that not enough dentists participate as it is and worries that Denti-Cal isn’t prepared for the hundreds of thousands of new children coming into the program in the next few years. This will be primarily as a result of the transition of children \u003ca href=\"http://www.dhcs.ca.gov/services/Pages/HealthyFamiliesTransition.aspx\" target=\"_blank\">from the publicly-funded Healthy Families program into Medi-Cal\u003c/a> and the expansion of Medi-Cal under the Affordable Care Act.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“If it’s this way now, we should be worried about the future for sure,” she said.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/9305/how-many-dentists-accept-children-on-medi-cal-new-report-says-one-in-four","authors":["8344"],"categories":["stateofhealth_14","stateofhealth_13"],"tags":["stateofhealth_380","stateofhealth_99"],"featImg":"stateofhealth_9308","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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