Dental care for the underserved: the Michigan Community Dental Clinics (MCDC) approach

tanya

People with chronic diseases who are not well educated about their health status might delay health care, and they may gradually notice the bad consequences of this decision in the long term when it is usually too late and more expensive to access health services. In contrast, it is harder to delay care when people have dental problems that cause extreme toothaches. This will generally make people reach for an immediate visit to the dentist because it tends to be an unbearable discomfort. Now, what to do if your insurance does not cover dental care or if you are uninsured and low income? It is a very unfortunate situation faced by a lot of people who fall into these categories.

Access to dental care for Medicaid recipients and low-income uninsured persons is very limited. MCDC developed a social entrepreneur approach to address this important public health issue. The clinics offer dental care to adults and children on Medicaid, and to low income, uninsured individuals, integrating health education to modify health behavior in order to avoid dental visits under very painful emergencies, promoting preventive care. The model is unique because it meets two challenging goals at the same time: providing timely dental care to the underserved while maintaining a successful business model.

MCDC is a not for profit corporation that assists in the development of dental clinics by Local Public Health Departments (LHDs) in Michigan. It is a Private-Public partnership model: LHDs create the clinics based on MCDC requirements, and MCDC leases the clinics and provides qualified staff to manage the facilities, including the maintenance of dental equipment. MCDC receives an enhanced Medicaid dental services rate –through a mechanism created by the State of Michigan and Centers for Medicare and Medicaid Services– allowing for break even operation of the clinics. MCDC offers several programs including the Michigan Community Dental Plan for uninsured patients who are 300% below the Federal poverty line. These patients are charged with reduced fees that cover costs, and receive comprehensive dental services. In addition, the quality of services provided by the clinics is not compromised by this business scheme. The clinics are patient-centered, which is reflected in high patient satisfaction rates of 90% during 2013.

This interesting approach sets a good example for other providers to be able to include underserved populations in their practices. This way, quality dental care that places great emphasis in prevention meets an efficient and productive business model that could be escalated to other communities that have limited access to dental services.

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