Listening To – and Learning From – the Oral Health Safety Net

Colorado’s 2015 Safety Net Clinic Week is celebrating health care safety net clinics and providers who serve Colorado’s most vulnerable residents. There is much to celebrate as well as much to learn. 

The Colorado Health Institute (CHI) surveyed oral health safety net leaders to understand the impact of recent changes in Medicaid. Findings from the survey are revealed in a new report, “Without a Net: Understanding the Impact of Medicaid Expansion on Colorado’s Oral Health Safety Net.” The results suggest that the oral health safety net is struggling to meet higher patient demand with current funding sources. 

Colorado expanded Medicaid to more low-income residents in 2014 and also began providing dental benefits to adult enrollees. These policies were an important step toward improved oral health. Today, about one of five Coloradans has a Medicaid dental benefit. 

But with more Medicaid patients than ever before, the strength and resilience of Colorado’s oral health safety net is being tested. 
Clinics report full schedules and lengthy waitlists for some services, including specialty dental care. The Medicaid dental benefit sparked higher patient demand that is unlikely to level-off anytime soon. 

Safety net clinics are working on all cylinders now but planning for the future at the same time. Most intend to hire new staff and expand clinic space, programs and hours. They also see promise in pursuing innovative models of care delivery, such as medical-dental integrated care and tele-dentistry or Virtual Dental Homes. 

These organizations want to serve more patients, improve quality and be financially sustainable. Yet Medicaid reimbursement, patient fees and grant funding is currently not enough to support these plans. 

Policies have paved the path to improving oral health in Colorado. Findings from the survey suggest that providers, advocates and policymakers have more work to do to support the oral health safety net and ensure access to all who need care. 
Read the full report here.