We received back the following thoughtful responses and hope they provide an opening for discussion for positive changes for Medicaid dentists.
1. Our DMO surveys show a continuing dissatisfaction with MCNA and DentaQuest especially over dental homes shifting and refusal to approve medically necessary treatment. What do you think is the solution here?
The main dental home solution is a simple one & has been presented multiple times but has been consistently opposed by the TDA. Texas is the only state in the nation that assigns the main dental home, or MDH, to an individual provider. Everywhere else assigns MDH to an office location, IE address. Making MDH assigned to the location and not the provider would fix the entire issue and promote easier access for children’s care.
Regarding medically necessary care, the MCO’s are in no position and should have no authority to determine that. The determination of medically necessary care should reside solely with the treating clinician.
2. One dentist contacted us and told us that his patients are being contacted by HHSC and being given the hard sell to move over to United Healthcare. What do you think about it?
Medicaid members (patients) should have the freedom to elect the MCO of their choice. United Healthcare needs to show itself as consistent and competent before receiving patients, and patients definitely should not be forced to change.
3. Our survey results show that most dentists aren’t sure how United is going to work out. What are your thoughts on this?
So far United has struggled tremendously during trainings and their personnel have been unable to answer basic questions. It does not appear that United is currently ready to take on 1 million Texas’ kids and their dental care.
4. Our survey results show that there is a gradual lessening every year in the percentage of dentists who feel like quitting Medicaid but the majority are still frustrated. What do you think is the solution to this?
I believe the state and the MCO’s would do well to recognize the complicated nature and intense needs of these Medicaid pediatric patients. Currently, it seems all of the decisions made by the state and MCO’s are financially-based, which leads to frustrating policies that complicate and limit access to care. If the state and MCO’s could shift their focus to the well-being of children and good oral health, then the policies enacted would likely facilitate better care rather than get in the way.