Oregon Health Authority Aims To Bridge Dental Care Gap

More studies have come out on why lower-income insurance state insurance isn’t accepted by most Oregon dentists. I’m here to tell you it’s not just Oregon; it’s everywhere. And when they do accept it, it’s not very affordable. 

The Oregon Health Authority

Willamette Week highlights a significant issue: between 55% and 70% of Oregon dentists do not accept patients on Medicaid, particularly affecting low-income individuals, especially in rural areas. The Oregon Health Authority (OHA) is aware of this problem and aims to improve access to oral health care for low-income Oregonians. They are currently investigating the reasons behind this reluctance among dentists. 

Pain and Suffering

My fiancée and I have two different insurances. Hers is a good one that paid for almost everything; what it didn’t pay for was very affordable. Expensive, yes, but at a price that made sense. At the time, we both had the same issue: we both had root canal surgery after a cleaning, and it was on the same tooth. My insurance covered the cleaning and about half of the surgery, let alone the crown. My lady’s covered both and half the crown. The price I was given for my crown was $1,700, while the full price for hers was $700.

I said, “Hey, wait a minute, what’s up with this injustice?” The dental office’s response was, “Well, her insurance negotiated the price better.” 

Corporate Greed

Now, friends, that’s all fine and good. If a company wants to rip off another company, who am I to stop them? But it’s awfully messed up that I, as a customer, am locked into a price that I have to pay for a product I don't want, I need, and some company that doesn’t care about me is in control of the price. They wouldn’t even give me the cash price, which was about $600 less, because I had already used my insurance. This is what I am talking about: corporate greed that gets pushed down on you, the customer when you are just trying to live a happy life. 

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Research Team

The OHA’s research team, led by Jon McElfresh, interviewed state officials managing the Oregon Health Plan (OHP) and dental practices. They found a notable disconnect between state officials’ views on OHP's accessibility and dentists’ experiences. Key challenges identified by dentists include a tedious claims process, insufficient coverage for many essential procedures like wisdom tooth removals and dentures, and communication gaps that lead to unexpected claim denials after submission.

 The recommendations made to address these challenges are crucial. Increasing Medicaid reimbursement rates could make accepting OHP patients more financially viable for dentists, while a better communication and outreach plan could inform dental practices about covered services and reduce misconceptions about OHP.   Addressing the identified challenges may help increase the number of dentists willing to accept Medicaid patients, ultimately improving oral healthcare access. 

In the end, it’s a matter of fairness and justice in healthcare. No one should have to fight for basic access to necessary services. Let’s hope for change that benefits everyone, especially those who need it most.