Back in December, TDMR asked dentists to take an online survey to ascertain their views on Texas Medicaid dental managed care. We now have these results which are provided below and can be downloaded.
Limitation of survey results
Before we discuss the results, we want to add some provisos here. This was an entirely open and anonymous survey. No effort was made to qualify those who answered the questions to make sure they were actually Medicaid dentists. There was no attempt to obtain randomized results which would be more accurate and we assume that those who were dissatisfied with managed care were more likely to respond to the survey than those who are satisfied. There was also an initial design flaw which allowed those who did not self-identify as dentists to complete the survey. After this was noticed, the survey was adjusted so this could not be done.
Despite these factors, we think the results are interesting, useful and should be taken seriously by both the companies involved, MCNA and Dentaquest, and their government overseer, Texas Health and Human Services.
Almost 20% didn’t complete survey despite anonymity
The most interesting factor we found from conducting this survey and analyzing the results is not seen directly in the results themselves. It was the surprising number of dentists who skipped answering certain questions in the survey. This factor was not anticipated in the original design of the survey but was noticed early on. So the survey was adjusted so that if a question was skipped, the individual could not move forward until that question was answered. Apparently, the fear of actually completing the survey became so great that roughly 17% ended up abandoning the survey after they were asked to provide their opinions about the two MCOs. This is a surprising level of fear.
MCNA rated “terrible,” Dentaquest “needs some improvement”
Perhaps unsurprisingly based on the number of previous stories we have written about MCNA, the largest number of dentists, some 43%, rated MCNA’s performance as “terrible.” The largest number of dentists, some 37%, rated Dentaquest’s performance as “needs some improvement.” Only 6% rated MCNA’s performance as “excellent” while 18% felt that way about Dentaquest.
What specifically didn’t individuals like about MCNA? The top four complaints were:
- Not approving medically necessary treatment. – 66%
- Dictating treatment against my judgment. – 62%
- Dental homes keep switching. – 52%
- Can’t treat emergencies immediately and expect payment. – 45%
- Dental homes keep switching. – 40%
- Not approving medically necessary treatment. – 36%
- Credentialing takes a long time. – 29%
- Dictating treatment against my judgment. – 28%
Did issues get resolved with companies?
In answer to the severity of the problems experienced, 40% of dentists said they had “a serious issue(s) that I cannot get resolved and is still outstanding” with MCNA. With Dentaquest, the most popular answer was “a few minor problems easily resolved with the company” at 37%.
HHS ineffective at dealing with provider issues with MCOs
Roughly half of the dentists experiencing problems attempted to contact HHS. Was HHS responsive and helped to resolve issues? 100% of dentists who contacted them DID NOT get their issue resolved. A sad commentary.
Majority of dentists “frustrated”
This section speaks for itself. When asked about their state of mind, dentists answered:
Very happy 4.88%
Very upset 7.32%
On the verge of quitting 15.85%
Dentists open to contact
TDMR is very pleased that 28 dentists out of 105 volunteered to be contacted by us about their experiences with managed care. We wish to thank them for this and we will endeavor to be in touch as quickly as possible.
Invite response to results
We invite commentary on these results from the companies, from HHS and anyone else.
Please note we have upgraded our PDF viewer. You can now download the PDF file directly from the toolbar on the bottom of the PDF and also make the PDF go full-screen without download.TDMR DMO Survey results