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What You Need to Know About Healthcare Reform for Your Dental School Interview

In recent years, dental schools are looking more and more at applicants’ knowledge and understanding of dental health care delivery.  As you prepare for your dental school interview, it is wise to consider these issues in general and how recent healthcare reform will impact dental care and the dental profession.

To make sure you have the necessary preparation to ace your interview, try to gain a basic understanding of the issues revolving around healthcare reform’s impact on dentistry.  Avoid getting caught up in details and memorizing every fact about healthcare delivery in dentistry. Dental school admissions committees are not going to quiz you on your knowledge of details.  The goal is to demonstrate an overall understanding of the issues and formulate a position that shows the dental admissions committee your thoughtfulness.  In an attempt to help you prepare, below we have highlighted some of the key issues relating to the impact of healthcare reform on dentistry:

Before we consider how healthcare reform will affect dentistry, it is worth looking at government programs designed to provide oral heath services for the population.  Government programs generally tend to cover healthcare services, including dental services, for vulnerable populations such as those who do not make too much money.

There are two mechanisms through which the government provides oral healthcare services to low-income communities:

Medicaid: Medicaid is a government program that pays for healthcare services for certain groups who are considered low-income and for individuals with certain kinds of disabilities. The program is funded by both the federal government and the state and run by the state.  Medicaid covers dental services for children in all states.  In some states, Medicaid also covers dental services for adults.

Children’s Health Insurance Plan (CHIP): Like Medicaid, CHIP is also a government-based program funded by both the state and the federal government that provides coverage for healthcare services to children from low income families.  Like Medicaid, CHIP also covers dental care for children.

The Impact of the Affordable Care Act (ACA) on Dentistry

Expanding Medicaid: One of the key provisions of the ACA is to expand Medicaid coverage, making more families eligible for Medicaid.  This provision may have different impacts in different states because some states may opt to not expand Medicaid services, but in states that do (so far 31 States have expanded Medicaid), more individuals and families will be eligible for Medicaid.

Impact on dentistry: As Medicaid expands, more children (and in some cases adults) will be able to receive oral health services including screening and treatments.

Individual Mandate: The ACA now requires individuals to purchase health insurance or pay a penalty.

Impact on dentistry: The mandate does not require individuals to purchase dental benefits as a part of their insurance plan. However, as more people begin to shop for health insurance to cover medical care, especially through the exchanges, they may also opt to purchase dental insurance alongside their medical coverage.

Establishing Heath Insurance Exchanges: The ACA has led to the introduction of health insurance exchanges, which are like online shopping malls for private health insurance plans.  Individuals and small business can visit such exchanges online and compare the price of different health insurance plans.  The exchanges provide financial support (subsidies) for those who make too much money to qualify for government insurance plans like Medicaid but who still do not make enough money to pay for health insurance on their own.

Impact on dentistry: All insurance companies that sell health insurance plans through the exchanges must provide coverage for pediatric dental services as a part of this plan.  As a result, any child receiving health insurance through the exchange will have dental insurance coverage.

Coordination of Care: A major focus of the ACA is to promote better coordination of care between various providers.  One mechanism for improving coordination of care is through the introduction of accountable care organizations (ACO).  These organizations encourage primary care physicians to communicate with other healthcare providers with respect to patient care.

Impact on dentistry: Dentistry has only been incorporated into the ACO model of coordinated care to a limited extent.  However, if there is more integration of dental care into coordinated care schemes, it would translate to greater communication between primary care providers, medical specialists, and dentists.  This could enhance oral health care and enable dentists to provide oral health services in the context of overall health with greater awareness of the patient’s coexisting medical conditions.

Impact on Dental Practices: The majority of dental practices are considered small businesses.  The ACA does not require small businesses to provide health insurance coverage to full-time employees but it encourages dental practices to do so by providing tax incentives.

Impact on dentistry: Practicing dentists will be more inclined to provide heath insurance for their full-time employees or potentially to move their employees to part-time employment to avoid having to pay penalties.