A day ago we closed off our Texas Medicaid Dental Maintenance Organization Annual Survey 2019 and have tallied the results to share. We are pleased that we were able to attract 101 individuals to take the survey which is more than double over last year.
Again, we must repeat a warning that this survey is anonymous and informal. The answers are based on the honor system and we are trusting those individuals who answered it, were not ringers.
Dissatisfaction has grown
The bottom line is that the depth of dissatisfaction of dentists with the system has grown. This undoubtedly accounts for the slight drop in the number of dentists actually in the system.
A year ago, 22% of those answering were satisfied/very happy with how things were going. Today it is 18%. Those on the “verge of quitting” and “very upset” grew from 21% to 27%. The number of those considering quitting alone doubled from 9% to 18%. (Question 8)
DMO performance still upsetting
In relation to the performance of the DMOs, DentaQuest and MCNA, it is pretty much same old, same old. Over 50% of those responding reported either minor or major issues they cannot get resolved with either company. (Question 4&5)
As far as grading their performance, it is roughly the same as 2018 except that some respondents now rate their performance as “excellent” (none last year) whereas significantly more than last year say they’re “still terrible.” (Question 2)
Some big problems with DMOs lessened
A bright spot for both companies is that those answering reported that both companies have lessened their tendency to “dictate treatment against my judgment” and the problem of credentialing has reduced greatly. In 2018, over 50% of those answering the survey stated that their biggest problem with either company was dictating treatment. This has dropped down to 17% for DentaQuest and 22% for MCNA.
Biggest problem is not approving medically necessary treatment
This year’s largest problem for both companies is “not approving medically necessary treatment.” For shame. (Question 3)
It is interesting that the Legislature has passed a series of measures related to MCOs that are sitting on the desk of the Governor for his signature, according to the Dallas Morning News [paywall, unfortunately].
“The biggest patient protection that cleared both chambers is the creation of an independent arbiter to review cases when so-called managed care organizations, or MCOs, refuse to pay for doctor-ordered treatments and equipment. That “external medical reviewer” represents a potentially life-saving safety net for patients like D’ashon, who currently must exhaust appeals with MCOs, and then if they’re determined enough, scale a faulty medical appeal system that heavily favors companies.
“Three key bills include other protections, such as more transparency and a bit more oversight — not enough, patient advocates say – around the opaque and ever-changing rules companies cite as justifications when they deny services taxpayers have already paid for.”
It will be interesting to see if these can be applied to DMOs.
Will there be one of more new DMOs?
When it comes to the new contract and whether there should be a new DMO included or whether or not MCNA or DentaQuest will also be awarded, there is some schizophrenia.
Roughly half of those answering think MCNA and DentaQuest will be renewed while the other half think they won’t. (Question 6)
Similarly, it is almost 50/50 on whether or not a new contract will be awarded to another company. (Question 7)
Let us know what you think
If anyone would like to comment on our survey results, please do not hesitate to use the comment section below.
If there is a story you feel should be told, don’t hesitate to contact TDMR at firstname.lastname@example.org.