Dentists serving gov’t health plan beneficiaries lost $15.4M in ’17
Dentists who provide services to the Puerto Rico Government Health Plan reported a loss of $15.4 million for the fiscal year 2017 as a result of operational costs that were not covered by the rates paid by insurers to oral health providers, the president of the College of Dental Surgeons of Puerto Rico, Elba C. Díaz-Toro, said.
According to cited researchers’ analysis, the rates should increase from 8 percent to 100 percent or more, depending on the procedure, just so dentists can recover the investment in production costs and avoid economic losses as they have up to now, she said.
These losses do not include payment to dentists for their time, effort and expertise, Díaz-Toro further added.
The research was supported by the Graduate School of Public Health of the University of Puerto Rico’s Medical Sciences Campus. Researchers conducted an analysis on the use of expenses and costs of dental services on the island, including the Government’s Health Plan.
“This analysis shows that dentists as a class are subsidizing the oral health services of the Government’s Health Plan out of their own pockets,” she said.
“Dentists have demonstrated our commitment to address the oral health problems of the population insured by the plan, while maintaining the highest levels of quality,” Díaz-Toro said.
“However, the rates insurers impose on dentists can dramatically affect the availability of dental services when they jeopardize the economic viability of dental offices,” she added.
Hundreds of dentists have left the island — 89 this year and another 200 are requesting stateside licenses to practice — partly due to this situation, she said, citing Puerto Rico Dental Board statistics.
In recent decades, rates have not been adjusted to be in line with the economic changes that influence the operating costs of dental offices in Puerto Rico.
This, coupled with the aging of the population, migration and the island’s economic impoverishment, are factors that are negatively affecting these services. Another problem, she said is that insurers maintain closed networks, preventing young dentists from replacing those who retire and forcing them to emigrate to the U.S. mainland.
“If this situation is not resolved in this next renewal of Government Health Plan contracts, Puerto Rico runs the risk of losing everything gained in oral health and consequently, in its general health, when health reform patients were given access to dental services. Each dental office is also a small business that produces jobs and contributes to the local economy,” Díaz-Toro said.