Geographical gaps in the availability of dental care in Kansas have been an area of concern for some time, but those gaps are becoming far more serious for Kansans who depend on the state’s new Medicaid program, known as KanCare.
Dental services for children always have been included in Medicaid coverage, but KanCare extends coverage of preventive dental services to adults. That sounds great, but coverage of those services doesn’t necessarily mean that adults will be able to access care.
Information collected by the Kansas Department of Health and Environment last summer indicated that 13 Kansas counties didn’t have a single dentist practicing within their borders. That, in itself, is a significant problem. However, more recent data collected by KDHE indicate that 37 counties, more than one-third of the counties in the state, have no dentist who will accept KanCare clients. According to the Kansas Dental Project, that leaves more than 28,000 Kansans who can’t access the dental care covered by the KanCare plan without traveling to a neighboring county or, perhaps, across several counties in western parts of the state.
A Dental Project representative noted that KanCare clients in a number of other counties also may have to travel outside the county for dental care. The clients must choose from among three private managed care organizations for all of their care, and if the dentists in their county only contract with one or two of the private companies, there may be additional service gaps.
One move that likely would help close the gap is the creation of a new category of “registered dental practitioners.” The Kansas Dental Project has proposed legislation to allow dental hygienists who receive advanced training and pass a comprehensive clinical exam to work under the supervision of a dentist to provide routine and preventive care.
Having registered dental practitioners in underserved areas of the state may be part of the solution, but the large gaps in KanCare dental coverage also indicate that many dentists in the state are unwilling — for whatever reason — to provide services through the new Medicaid system. Whether it’s convenience, cost or some other issue that is causing them to shun the system, it’s up to state officials to work with dentists to make sure KanCare clients not only have coverage but can access care within a reasonable geographic area.