This Is Happening in Wisconsin Not Appalachia:

First, apologies to those who can’t access the article…JSOnline has this one behind their pay wall: Lake Area Free Clinic saw the need for better access to dental care — and did something about it. But I am going to quote as much of it as I can…that I deem relevant.

We’ve all gotten somewhat used to reading about non-profit health care providers visiting the poorest parts of our nation and filling the gaps in American healthcare with free services. But the quotes that I am copying in below refer not to Appalachia or the slums of our major cities…but one of the richest (and reddest) counties in Wisconsin.

The response when Lake Area Free Clinic opened a dental clinic shows the limited access to dental care for people without dental insurance or covered by BadgerCare Plus or other Medicaid programs.
The clinic also shows the work that some nonprofit organizations have done to help lessen the problem.

Lake Area Free Clinic in Oconomowoc was founded in 2001 to provide medical care to people without health insurance. It opened a dental clinic in late 2017 — and almost immediately was seeing more patients seeking dental care than medical care.

“Many of them haven’t had access to dental services in years,” said Mary Reich, executive director of Lake Area Free Clinic.

The clinic had 7,686 patient visits last year, and 4,190 of them were for dental care.

The response probably wasn’t a surprise. In 2017, more than 700 adults received care for emergent dental conditions, such as severe pain from an infection, at the emergency departments of ProHealth Care’s hospitals in Waukesha and Oconomowoc and at Aurora Health Care’s hospital in Summit.

Lake Area Free Clinic provides dental care only to adults. That’s because Waukesha County Community Dental Clinic, founded in 2008, focuses on providing care to children at its clinics in Waukesha and Menomonee Falls. Its clinic in Menomonee Falls opened last year with a gift from Froedtert Health.

Lake Area Free Clinic’s board decided to build the dental clinic after a survey of dentists in Waukesha County who accepted patients covered by BadgerCare Plus and other Medicaid programs found only one who was taking new patients.

“We were getting desperate calls from people,” said Megan Welsh, director of marketing and development for the clinic.

Not surprisingly one of the reasons for lack of care is the low reimbursement rates for BadgerCare Plus.

Dentists in private practice don’t accept or limit the number of patients who are covered by Medicaid programs because the reimbursement rates don’t cover the cost of providing care.

According to the Wisconsin Dental Association, the programs pay:
$34.61 for children and $42.41 for adults for a basic exam and cleaning.
$34.58 for children and $32.57 for adults to fill a cavity. 

Those rates are one-third to one-half — or less — of what commercial insurance will pay, with the exception of the reimbursement rate for a basic exam and cleaning for children.

Madison had a chance to improve this a bit but along with removing the ACA available Medicaid expansion from the state budget…the GOP lawmakers removed money for added dental care too. Ironically, it would have helped constituents in a solid GOP county.

Dental care accounts for about 1% of the state budget for health programs.

Gov. Tony Evers proposed a roughly 20% increase in what the state spends on dental care for children and adults — the first significant increase in spending on dental care in more than 15 years — but the proposal was rejected by the Legislature.

Lake Area Free Clinic stays away from politics. But Reich acknowledged that the clinic would have benefited from the governor’s proposal to increase reimbursement rates 50% for nonprofit clinics if half of their patients were covered by Medicaid programs.

The clinic bills the state or the managed care organizations that contract to manage the care of people covered by BadgerCare Plus. Co-pays and contributions make up the shortfall.

Lake Area Free Clinic was booking dental appointments three to four months out before adding a full-time dentist. That’s now down to about six weeks out, with about 250 people waiting to get dental care.

“There still remains a significant waiting list,” Reich said.

I am not sure what else to say…we need a comprehensive universal healthcare plan to cover everyone…the people using Lake Area Free Clinic should have access to affordable and timely dental care (and health care)…as should everyone else. And the Free Clinic model should go the way of buggy whip makers.

And shame on the Milwaukee Journal Sentinel and JSOnline for putting a healthcare article behind their pay wall…this is the type of news that should be out front and available to all.


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