Myths Vs Facts

MYTH: Increasing the Medicaid reimbursement rate will allow more people to see dentists.

FACT: Raising Medicaid reimbursements will help some but increases in access are mostly modest and very expensive. More is needed in Florida to solve the oral health crisis.

Raising Medicaid reimbursement rates is an important but insufficient strategy to solve the access problem. The literature on raising Medicaid reimbursement rates to increase utilization suggests only a small positive impact with modest increases that are very expensive compared to the gains.

A National Bureau of Economic Research paper found that raising Medicaid child dental payments from 52% to 85% of average dentists’ fees would only yield a 9% increase in utilization, or an average of 0.12 extra visits per child per year. Furthermore, a Wisconsin study released in February 2019 found that more than doubling the Medicaid reimbursement rate for dental care in four counties (from an average of 36% of private insurance reimbursement) resulted in only a 4-percentage point increase in child utilization after one year of rate hikes. 

Increasing Medicaid payment rates also does nothing for nearly SIX million Florida residents who live in dentist shortage areas, where they already have trouble finding a dentist. There will still be sizable areas of the state with few or no providers and there will always be populations that find it difficult to travel to a dentist’s office. Raising reimbursement rates, like so many other initiatives, is not a silver bullet to solving dental access challenges. 

Raising Medicaid payment rates to perpetuate a system where only dentists – the highest paid member of the dental team – provide routine care is a highly inefficient use of Medicaid dollars and creates no incentives for dentists to extend their reach into underserved areas.