Medicaid Dentist Practice Problem

I agree that many dentists won’t accept Medicaid as a whole in the United States.  For example, in Chicago, many patients seem to be on Medicaid, particularly in the Hispanic and African American communities.  With larger numbers of poorer communities in bigger cities, you see more dentists accepting since this proves to be more of a lucrative option at times.

Many dentists face problems with Medicaid patients.  Some of the biggest problems are the no-show, cancellation, lack of follow up on their appointments.  This does cause the dentist, and the office in general to lose money on the overhead.  Not only does Medicaid reimburse much lower than private insurances, sometimes dealing with Medicaid patients can be a troublesome, grueling process.  These patients coming from poorer neighborhoods have a lack of proper education, and at times can lack the proper ‘etiquette’ when it comes to communication between the dentist and the patient.

All these factors can deter a dentist from going into a medicaid practice.  However, with proper management, medicaid practices tend to be more profitable than most private clinics when seen in a volume.  This does however, mean that patients must be treated more efficiently with limited amount of  time- this would mean cutting out procedures that don’t make the chairtime worthwhile, ie (in Chicago) full dentures, post/core buildups, crowns, and posterior root canals.  With larger numbers of  patients, a dentist would have to work much harder to see the same numbers at cash based/insurance clinic. 

Many times, a patient who has insurance, or is paying cash for treatment, tends to be turned off if a dentist is found to accept medicaid, or if there are medicaid patients among them at the clinic.   Hispanics don’t tend to care about this as much, and their main concern being if the clinic can speak Spanish.  However, with other ethnic communities, the inner socio-economical discrimination within their respective race is pretty evident.  This is another reason why dentists don’t want to lose their good, ‘profitable’ patients.

The majority of dentists in the United States are Caucasian.  There are many Asian/South Asian dentists as well.  Nowadays there aren’t many graduating Hispanic and African American dentists embarking on the profession.  Many of the African American dentists do tend to stay with their communities and help their people as much as they can.  The Hispanic dentists do the same for their communities.  You will also find many Asian/South Asian dentists setting up more Medicaid practices in the African American and Hispanic communities as well.  In Chicago, you will rarely, if ever see Caucasian dentists based in poor African American neighboorhoods and generally tend to stay away from Medicaid patients.