Wis. weighs options for improving access to care

Wisconsin currently has enough dentists to meet the state's demand for access to quality dental services, although access for low-income and uninsured individuals remains a challenge in some areas, according to a new report commissioned by the Wisconsin Dental Association.

The year-long study, "Supply and Demand for Dental Services: Wisconsin 2010-2020," was conducted by University of Connecticut researchers Howard Bailit, D.M.D., Ph.D., and Tryfon Beazoglou, Ph.D. It was designed to estimate the supply and demand for dental services in Wisconsin from 2010 to 2020 and to discuss options for reducing access disparities, according to a WDA press release.

The study reviewed data from the State Medicaid program, Delta Dental of Wisconsin, a survey of general practices and federally qualified health center dental clinics, and state and national resources on dental providers and population demographics. Using a market model of supply and demand for dental care, the expected number of dentists and demand for care was estimated for the state and for individual counties.

The results suggest that growth in dentists (6.25%) and population (6.70%) will be approximately equal over the next decade, keeping the dentist-to-population ratio relatively constant (1/1,803). The expected rise in dentist productivity (2.6%) will outpace the expected growth in demand for care (1.6%). As a result, in 2020 Wisconsin residents with the resources to purchase dental services in the private sector will have the same or better access to dental care than the current population.

Geographical disparities

In some areas of the state, however, access to dental care for low-income and uninsured individuals and people in the state’s growing medical assistance programs is a challenge due to underfunding by the government and the economic reality that dentists, as small-business owners, tend to settle where economic demand for their services remains high.

The also report found that the state's 3,142 dentists are very efficient and productive, utilizing dental hygienists and assistants much more effectively than their counterparts nationally.

"These two basic findings alone give us confidence that if we can find and implement programs that build upon the existing dental care delivery system, we can address the access problems in our state in a manner that is both efficient and ensures high quality care," noted WDA President Kent Vandehaar, D.D.S.

Bailit and Beazoglou note in their report, "Finally, it bears repeating that just increasing the number of dentists in the state without increasing demand will have little impact of reducing access disparities. Most of the new dentists will locate in the more affluent counties and mainly treat patients that can pay for their services. If they cannot make an adequate income with this strategy, most will move to other states."

To reduce disparities, the state needs to provide the underserved population financial resources to purchase the care in the private system or greatly expand the safety net system, they added. "In either case, the state will be required to substantially increase Medicaid dental budgets."

Delta Dental of Wisconsin supported this follow-up to the 2001 Wisconsin dental work force study, which was conducted by the same research team, with a grant of $87,000.