Inflation and Low Fees Driving Medicaid Dental Providers Out of the Program

TDMR received this letter highlighting the difficulty Medicaid dental providers are having in today's current economic climate and the need for the legislature this session to take corrective action.

We publish it in hopes that it will reach open and receptive minds at the Legislature.

I am writing to you in response to your story about various states increasing their Medicaid fees and that Texas is not one of these states. TDMR highlighted this discrepancy, but the toll that inflation and continuing low fees are taking on Texas Medicaid dental providers needs to be shouted from the roof tops.

It is no secret that Medicaid dental rates have not increased in 15 years and that there have been several small decreases over the past decade. This fact, along with historical inflation levels since the pandemic, has meant that many Medicaid providers in Texas that are not part of a big company/ DSO are facing an existential crisis. I have seen more and more of my friends and colleagues divest out of their own offices to escape the financial pressures and become associates of large DSOs.

Indeed, corporate dentistry is slowly swallowing up most small dentist-owned groups and single offices. Many are leaving the Medicaid program.

Just look at inflation. Since 2007 it is around 40% when factoring in the recent jumps. But for dentists, it is greater when you factor in the exploding costs of supplies and dental materials due to supply chain issues, as well as the need for additional PPE and better universal precautions.  Forget 40%. Many of the top categories of spending for dentists have more than doubled over the last ten years. Worse, when paired with a historically tight labor market and higher-than-ever wages, dentists struggle to survive in Texas.

Texas needs to do right by its providers who care for the state's underserved children and increase its reimbursement fees as so many states have recently done.

Most of us have heard about the unprecedented budget surplus in the state coffers. We wonder if those in power will apply a minuscule portion of this mountain of riches to help healthcare providers survive and serve the children of Texas.

One would hope that will be the case.



6 Responses

  • Please raise fees so doctors who care and get reimbursed for the overhead and continue to provide quality care for children.

  • It’s been very difficult these past couple of years with inflation and costs being so high. The number 40% inflation since our last fee increase for Texas Medicaid is mind blowing. I cannot think of another healthcare program which makes it so difficult for providers. I’m not shocked that so many of our colleagues are divesting and am hoping the state does right by our providers to provide optimal patient care with this surplus. That would be helpful for providers who care for their patients, their staff, and their business to provide optimal care, and additionally provide better access for care for patients who need it.

  • This is so very true. Material, labor, and rent all have increased. Our fees are unable to break even for many procedures. No one is helped if we continue to go out of business. Common sense tells us this can not continue or something in the system will break.

  • I haven’t taken a distribution in over a year. I pay my staff 60% more today than I did 18 months ago. My supplies have doubled in cost yet reimbursements haven’t changed in nearly two decades. Something has to give

  • The cost of dental materials and equipment is skyrocketing. Basic operating supplies costs continue to increase. Hourly wages for staff have now reached the point that I’m considering different ways to operate with fewer employees. There absolutely must be a fee increase to be able to continue to provide care to Medicaid patients.

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