Dental Medicaid spending grows with ADA advocacy

Baltimore鈥擥overnment actuaries report a “significant acceleration” in Medicaid dental expenditures in 2007 as overall health care spending slowed to its lowest rate of growth since 1998.

“Recently, some states have taken steps to increase access to dental care by increasing provider payments and streamlining billing practices,” said the government’s annual health spending report prepared by the Centers for Medicare & Medicaid Services Office of the Actuary.

Medicaid spending for dental care grew by 13.9 percent in 2007, sharply higher than the 2.7 percent growth in 2006.

ADA President John S. Findley, commenting on the report, said it speaks to the importance and effectiveness of public affairs advocacy. “These annual spending reports traditionally have acknowledged dentistry as only a minor line item in the trillion-plus dollar health economy, rarely commenting on dental spending trends. The report reflects the fact that states have responded to increasingly vocal dental advocates by significantly increasing the public dental budget, at least during 2007,” he noted.

“The Association and our tripartite profession and public health partners have an important access message. We have a strong voice, and we’re heard,” said Dr. Findley, adding, “This is owed in no small part to the ADA State Public Affairs program.”

The Association is at the forefront of a public policy push for increased access to care, calling for fundamental change to dental Medicaid at congressional hearings last year and enhancing the details in policy approved by the ADA House of Delegates at annual session. “Access is a key to good oral health,” says the ADA policy statement approved in Resolution 38H-2008.

Increasingly in the wake of a 12-year-old Maryland boy’s death Feb. 25, 2007, from complications of an untreated oral abscess, members of Congress, public health interest groups and the national media have joined the Association in focusing attention on dental Medicaid’s shortcomings. CMS analysts say the recent sharp increase in dental Medicaid spending offers evidence of an advocacy payoff, citing public attention to Deamonte Driver’s death as a key factor in spurring the increase.

Benjamin Washington, a CMS Office of the Actuary statistician, cites as reasons for the dental spending spike increased access to Medicaid dental care, states discontinuing cost containment strategies and supplemental payments to providers. The government’s annual health spending report also refers to media coverage of the dental reform movement.

Total Medicaid expenditures grew at a comparatively more modest 6.4 percent rate to $329.4 billion But the dental share remains a drop in the bucket of Medicaid dollars spent on health care services, 1.5 percent in 2007, or just under $5 billion.

The ADA policy statement urges the government to fund public health benefit programs adequately. “Programs such as Medicaid and the State Children’s Health Insurance Program must ensure that vulnerable children and adults with inadequate resources have access to essential oral health care,” says Res. 38H-2008. The Association will promote a legislative agenda in the 111th Congress that embraces Medicaid, SCHIP and other access measures.

The government’s annual health spending report appears in the January-February 2009 issue of the journal Health Affairs .