Texas dental practices that see Medicaid patients continue to face significant challenges as the COVID-19 crisis continues into the fall, according to a new report released by the DentaQuest Partnership for Oral Health Advancement today. 

The report, based on an August survey of nearly 2,800 dental providers across 20 states, found that the vast majority (94%) of providers have reopened for most services, including routine care. However, practices continue to see lower patient and revenue volumes, fewer new patients and more patients without commercial insurance.  

The report shows that these issues are especially challenging in Texas, where 75% of surveyed providers reported reductions in patient volumes since the pandemic began, compared to the 62% of providers in other states. Similarly, 73% of these Texas providers reported less revenue, compared to 62% of providers in other states.   Nearly one-third of the 431 providers surveyed in Texas said they are seeing less than half of their overall pre-COVID number of patients. And 61% of these providers reported they are currently treating more patients without commercial dental insurance due to unemployment caused by COVID-19. 

“Oral health is critical to overall health, and it’s encouraging that most Medicaid dental providers have reopened to offer care to some of our most vulnerable patients,” said Dr. Myechia Minter-Jordan, president and CEO of the DentaQuest Partnership for Oral Health Advancement and Catalyst Institute, Inc. “At the same time, however, many providers are struggling to stabilize their practices. These issues are particularly acute in Texas, where teledentistry is not permitted, and where patient and revenue volumes have dropped for a much larger percentage of practices than other states across the country.”  

Despite the current Texas prohibition of teledentistry, providers are open to it. One in five of the Texas providers surveyed said they were confident they could use teledentistry to see patients, if given the chance.  

This report follows an earlier DentaQuest Partnership Survey, conducted in May, that revealed a significant confidence gap among a similar group of dentists and the need to adapt and redesign the care they provide.  

Overall, data from providers in the 20 states surveyed for the new report showed:   

• Lower patient and revenue volumes: Due to the changes in treatment protocols, many dental practices and clinics are limited in the number of patients they can see, which has led to significant decreases in patient and revenue volumes. Three in four dentists surveyed say that the maximum number of patients they can see each day has been reduced, with one in four reporting they can see less than 50% of their normal patient volumes. Only 35% of dentists report that their practices or clinics are experiencing normal or near normal levels of revenue. And only half of providers feel confident that they can get the personal protective equipment (PPE) needed to keep staff and patients safe.   

• Fewer new patients: Nearly half of dental providers (44%) reported seeing fewer new patients in a typical week than they did before COVID-19.  

• More patients without insurance: As a result of widespread job loss and Medicaid cuts, many providers are seeing a rise in the number of patients who do not have dental insurance. According to the survey, more than half (52%) of dental providers with knowledge of the insurance status of their patients say they have observed an increase in patients who have lost their commercial dental insurance because of employment associated with COVID-19. Dental providers in states like Colorado and Tennessee that have recently cut Medicaid dental benefits for some or all adults may see similar trends in the patients they treat.  

“This report highlights the need for urgent action,” added Dr. Minter-Jordan. “States must maintain and expand their adult Medicaid benefits. Providers and policy makers must embrace teledentistry and other innovations, and we must all move away from the outdated fee-for-service model and toward a value-based payment model that is more effective for patients and providers alike.” 

While a majority of dentists believe business will return to normal in less than one year, many say it will not necessarily look the same as it did before COVID-19. The pandemic is expected to bring a new wave of dentistry, creating safer and better ways of delivering care to patients. This includes procedural strategies like minimally invasive techniques and technological strategies like telehealth, as well as a shift to alternative payment models. One-third of dental providers anticipate an increased use of minimally invasive and/or limited aerosol-generating procedures to help with infection control long-term, and a similar amount are embracing telehealth or virtual platforms to help expand access to care.  

Read the full report: A Difficult Path to COVID-19 Recovery. Review a summary of the Texas findings.

About the DentaQuest Partnership for Oral Health Advancement

The DentaQuest Partnership for Oral Health Advancement is a nonprofit organization working to transform the broken health care system and enable better health through oral health. Through strategic grantmaking, research and care improvement initiatives, we drive meaningful change at the local, state and national levels. The DentaQuest Partnership is affiliated with DentaQuest, a leading U.S. oral health enterprise with a mission to improve the oral health of all. Find out more at www.dentaquestpartnership.org.