The Affordable Care Act, or ACA, mandated dental coverage for children but not for adults. That lack of coverage has continued to fuel a growing trend – emergency room visits for dental problems.
The Agency for Healthcare Research and Quality (AHRQ) reported that in 2013 there were 633.7 dental-related ER visits per 100,000 people between the ages of 18 and 44. Typically, antibiotics are prescribed for dental infection. Otherwise, little to nothing is done in the way of treatment, and the patients are referred back to their dentists.
However, most of those patients don’t have, and can’t afford, a dentist because they lack dental insurance coverage.
Even adults who do have some form of governmental dental insurance may find it hard to locate a dentist who will accept them. Medicaid reimbursement is typically substantially lower than private insurance payments, which has led to a dearth of dentists willing to accept Medicaid patients.
Emergency room visits for dental issues are very wasteful from a monetary standpoint and from a resource utilization perspective. These visits are typically write-offs for hospitals, and dental patients would almost always be better served in a dental clinic.
The exception is when a tooth infection has become systemic and results in hospitalization – in some cases, in the Intensive Care Unit.
Non-insured dental ER visits are not, generally speaking, the best use of emergency room resources. Emergency room doctors, nurses, and other staff are often challenged by the patient loads, particularly in urban areas. While uninsured dental patients are often suffering, and need relief, emergency room resources are better used for patients with more serious needs.
Are You Missing Opportunities?
Most dentists make some provision for emergency cases including after-hours coverage. Few dentists emphasize emergency services, though, and that’s understandable – emergencies interrupt an otherwise ordered and productive schedule.
You should reserve at least slot daily for dental emergencies. My dad is a very successful dentist in the southeast Indiana/Greater Louisville area. Growing up, I saw time and again where today’s emergency became tomorrow’s repeat patient.
When you advertise the availability of same-day emergency appointments, you’re differentiating yourself from your competition. And since patients today view all dentists as competent, and therefore interchangeable commodities, helping you stand out is one of the basic things your marketing has to accomplish.
If your appointment schedule and overhead allow, you might consider somewhat increasing the number of Medicaid patients you accept. No, the reimbursement isn’t great, but there are several arguments in favor of the idea:
Medicaid patients can give great testimonials.
Medicaid patients know people who aren’t on Medicaid, and can serve as referral sources.
Some money for seeing a patient is better than no money if you and your staff will be in the office anyway.
The first two points are consistent with the tenets of patient attraction – positioning yourself as the trusted dental expert, and using the power of social proof that testimonials provide. The final point is just common sense.
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