Dental Public Health Activities: Descriptive Summaries
St. Mary's County Pilot Dental Program- Archived Summary
The St. Mary’s County (Maryland) Dental Program began in June 2000 as a result of a unique partnership fashioned between the St. Mary’s County Local Health Department and the Maryland Office of Oral Health with two Medicaid managed care organizations (MCOs) and the Patuxent Dental Society, a component society of the Maryland State Dental Association. Prior to the partnership and the program, only 2% of dentists (1 of 44 dentists) in St. Mary’s County participated in the Maryland Medicaid Program (MMP) (statewide average – 18% in 2000) resulting in poor utilization of dental services for Medicaid-eligible residents. Through the efforts of the partnership, and under the leadership of the St. Mary’s County Health Officer, the development and consensus for the pilot project plan was finalized in April 2000. The purpose of the pilot program was to increase the number of practicing dentists in St. Mary’s County who participated in the MMP with the assumption being that increased provider participation would result in increased access to dental care.
The pilot was successful and has continued to be supported through the St. Mary’s Health Department. Originally, there were 5 key components to the program, each addressing provider’s previous major objections to participation with the program: (1) Higher reimbursement levels; (2) Reduced administrative burden on participating dentists; (3) Facilitation of credentialing and contracting process with MMP managed care organizations; (4) Elimination of pre-authorizations for all dental procedures except orthodontic and hospital-based services; and (5) Program administered by St. Mary’s Local Health Department to address negative history with MMP and historical high no-show rate of patients. Today, fiscal resources for the program include grant funds from the Office of Oral Health and a local Rotary Club, which total approximately $30,000. A significant change in the past several years has been the carve-out of dental services from the overall Medicaid program (Health Choice) to a single dental program, now renamed the Maryland Healthy Smiles Program.
As of September 1st 2012, the program continues to be supported through the St. Mary’s County Health Department. There are currently 14 participating dentists (or 32% of St. Mary’s County dentists), many of whom have participated since 2000. Of these, three are pediatric dental providers, one is an orthodontist, and the remaining are general family dentists. All three pediatric dental practices in St. Mary’s County participate in the Healthy Smiles Program. The participating dental providers no longer have an enhanced reimbursement schedule (MCOs had originally contributed to the successful pilot of the program by agreeing to raise their dental benefit fee schedule to 72.5% of area dental fees) and now accept the current fees and pre-authorization requirements as the rest of the state of Maryland. However, reimbursement fees for many Medicaid dental service procedures increased to the American Dental Association 50th percentile as a result of state dental reform measures. The St. Mary’s County Health Department provides transportation to any clients in need. The compliance rate for patients keeping appointments for their dental care remains high, although the actual percentage rate is not currently available. The participating dentists also contract independently with the St. Mary’s County Health Department to provide emergency dental care/pain relief to uninsured individuals referred by the local health department. They agree to accept the same reimbursement rates as the MA fee schedule and the patient is requested to pay $50.
Contact Person(s) for Inquiries:
Harold S. Goodman, DMD, MPH, Director, Office of Oral Health, Maryland Department of Health and Mental Hygiene, 201 W. Preston Street, 3rd Floor, Baltimore, MD 21201, Phone: 410-767-5300, Fax: 410-333-7392, Email: firstname.lastname@example.org
Libby Blair RN, MS, Director of Health Services, St. Mary's County Health Department, 21580 Peabody Street, Leonardtown, Maryland 20650, Phone: (301) 475-4394, Fax: (301) 475-5430, Email: email@example.com