ADA.org: Future of Dentistry Full Report

FUTURE OFDENTISTRY

The Working Poor..........................................................................................................................

The working poor are defined as those people
who are employed in low-wage positions (i.e., 100-
200% of the poverty level) in economic sectors
where there is a lack of affordable private prepay-
ment programs. Programs to address the needs of
this population could include some level of financial
participation by the individual employee.
Public funding could provide the individual with
a stipend to subsidize the purchase of either a tradi-
tional prepayment plan or dental savings account.
The federal or state governments could address the
necessity to spread the risk by the creation of pools.
The administration of the program could be con-
tracted to the private sector.
This type of structure would empower the disad-
vantaged to make choices regarding dental care in a
manner similar to the rest of the population. By
bypassing the employer and going directly to the
individual, the difficulties of providing employer-
based prepayment for this segment of the market is
avoided. Individual employee contributions could
be withheld from wages.

Access Recommendation-2: New programs, subsi-
dized in part by public funding, should be developed
in which individual employees could purchase
insurance plans directly from risk pools if their
employers do not provide it.

The Disadvantaged in Geographically Isolated Areas......................................................................

Adequate availability of dental care is a problem
for the poor in inner cities and rural areas.
Financing care for the long-term unemployed and
the working poor are essential first steps to address
access. Additional efforts are needed to increase
availability of care for those groups in geographically
isolated areas. The dental profession should encour-
age dentists to provide services in these locales.

Access Recommendation-3: Effective incentives
should be offered to attract dentists to underserved
areas. These could include loan forgiveness, tax cred-
its or adequate reimbursement rates.

A program similar in design to the National Health
Service Corps would be beneficial in providing
increased workforce to underserved areas. Eligibility

for this program should not be limited to new den-

tal graduates. Older dentists and those in semi-

retirement may provide an important pool of per-

sonnel to address this issue. Long term funding at

adequate levels is essential to the success of this type

of program.

Access Recommendation-4: The National Health

Service Corps program should be expanded to help

provide dental care in the underserved areas.

Special Needs Populations and Individuals with Disabilities...........................................................

Access for special needs populations and individ-

uals with disabilities is difficult because of the special

needs of these individuals and the complex manage-

ment of their care. Many of these patients are home-

bound, institutionalized or unable to cooperate with

care in a traditional dental setting. Furthermore,

health providers require special skills and education-

al background to effectively manage some of these

individuals' health problems. Financing for the care

of this group of people will require reimbursement

rates at levels that will attract providers to undertake

the additional training necessary to manage these

patients. In addition, educational programs to train

providers with the necessary specialized skills should

be developed and widely implemented.

Access Recommendation-5: A publicly funded or

subsidized dental program should be developed for

people with disabilities, recognizing their special needs.

Access Recommendation-6: Outreach programs at

the state and local levels, which might include the

establishment of specialty dental clinics, should be

developed to meet the needs of patients unable to

receive care in traditional dental offices.

The Elderly.....................................................................................................................................

Utilization and access among the elderly have

increased resulting in much improved oral health.

This trend is likely to continue. Although many of

the elderly can budget for dental care without den-

tal prepayment, others might access care to a greater

degree if prepayment were available. There is evi-

dence that employers are reducing retirement-based

prepayment coverage for their former employees.

The development of a market-oriented solution to

Vision and Recommendations