ADA asks senator not to fund midlevel provider projects

The ADA is urging Sen. Tom Harkin (D-Iowa), who chairs the U.S. Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies, not to consider a healthcare appropriations measure that includes funding for the "alternative dental healthcare provider demonstration projects" that were created as part of the healthcare reform law.

According to a members-only bulletin released September 9, the ADA is asking ADA members in Sen. Harkin's home state to contact him and express their opposition to funding the demonstration projects, with particular emphasis on the following points:

• The existing dental workforce model is a proven delivery system.
• The dentist workforce is growing; five dental schools have opened since 2000 and more than a dozen schools are at varying stages of development.
• Dental practices have become more efficient. Today, it takes only 88 practices to serve the same number of dental patients as 100 practices during the 1980s.
• There is no evidence to support the economic feasibility of midlevel providers.
• A few states are already testing new dental delivery models, and scarce federal dollars should not be used to duplicate these efforts.
• Federal funding for oral health programs should focus on fully implementing the prevention and public health infrastructure programs, as education and prevention are the most cost-effective ways of minimizing untreated dental disease.
• A recent article published in the Journal of the American Medical Association concluded that increasing Medicaid reimbursements levels to dentists boosted the number of Medicaid-eligible children treated.

The ADA has expressed opposition to the midlevel provider model due to concerns that it might permit nondentists to perform irreversible/surgical dental procedures.