by Viktoria Sundqvist CTNewsJunkie
The Connecticut State Dental Association has sent a letter to the governor and several lawmakers urging them to prioritize Medicaid dental reimbursement rates in what they call an “access-to-care crisis.”
Medicaid beneficiaries are increasingly turning to emergency rooms for dental pain because of a shrinking provider network, long wait times and low-reimbursement rates for providers, said the group representing more than 3,000 licensed dentists in the state.
An estimated 2 million visits to hospital emergency rooms nationwide for dental pain annually is costing about $1.7 billion, according to the American Dental Association.
“These emergency visits, which typically cost three times more than preventative dental care, represent an enormous and avoidable strain on both our healthcare system and state budget,” the Connecticut State Dental Association said in its Jan. 24 letter to Gov. Ned Lamont.
“Continuing to neglect the Medicaid system will exacerbate short-term issues like tooth loss and increased ER visits for treatable dental pain, while the long-term effects, including missed screenings for conditions like oral abscesses, hypertension, diabetes, coronary disease and mental health disorders, are truly alarming.”
The group is urging Lamont to “take immediate steps” to prioritize Medicaid dental reimbursement rates and be too strict with the financial guardrails, which prioritize pensions over the care of citizens who need and deserve essential care.
“By raising reimbursement rates and addressing barriers to care, we can increase the number of providers willing to serve Medicaid patients, prevent costly ER visits, and improve overall public health outcomes in Connecticut,” the group said in its letter.
Connecticut’s hospitals said in December that one of the reasons they struggle with rising costs is due to low reimbursement rates for patients on Medicare and Medicaid, saying “what we get paid is far short of the cost of that care.” This, in turn, leads to additional costs for commercial payers, aka private insurance companies, who are reluctant to pay extra.
First responders have also raised an issue over Medicaid reimbursement rates, particularly addressing shortfalls for ambulance services.
Lamont briefly addressed health care costs in his State of the State address earlier this month, saying they are “consuming more and more of your budget and our state budget.” He also raised concern that the new administration in the White House would cut back on health care subsidies while Medicaid and other health care costs keep increasing. But he stressed that preventative care is key.
“We continue to encourage primary and preventative care, which keeps you healthier and keeps you out of the hospital,” Lamont said during his address.
The state in 2023 commissioned a study of Medicaid reimbursement rates. The first part of the study, released in 2024, indicated that Connecticut’s payments were below a benchmark set by peer states for 85% of the services analyzed and below a benchmark based on Medicare rates for 94% of the services analyzed. Part 2 of the study was expected to be completed by Jan. 1, 2025.
The Lamont administration has said it wanted to wait for the final part in order to make a more informed decision on reimbursement rates.