“The Denti-Cal system is broken – so broken that many dentists provide free care to patients rather than participate in the program,” says Wood.
“Last year, Senator Richard Pan and I requested that the Little Hoover Commission investigate the significant shortcomings of the program and its report, Fixing Denti-Cal, published in April this year, had much to say.”
There are many reasons the Denti-Cal program is failing patients and providers. Coverage for certain procedures is limited, utilization rates by beneficiaries are low, provider reimbursement rates are some of the lowest in the nation and dentists who want to become providers must submit a paper-based application that can exceed 50 pages and wait, sometimes more than a year, to be approved as a provider.
This bill requires the Department of Health Services (DHCS) to implement an expedited provider enrollment process, report utilization data more often and look for opportunities to increase patient utilization. Currently only 14 percent of all services provided are preventive services. Increasing utilization of preventive services can provide long-term benefits to both patients and the State by stopping more serious dental disease and by eventually shifting care away from more costly restorative care.
The public ranks dental care consistently as the most important type of health care after medical. Thirteen million Californians qualify for Denti-Cal – a third of the state’s population and half of our children. “The impact that good oral health has on a person's self-esteem and quality of life cannot be understated,” said Wood. “Children suffer unnecessary pain and adults with missing teeth struggle to find employment and social acceptance. It is our moral obligation to ensure the system works for patients and providers.”
Much still needs to be done to improve the Denti-Cal program, but this new law is a start by requiring DHCS to fix some of the critical administrative barriers that prevent dentists from being able to treat the program’s beneficiaries.