Vermont is experiencing a physician shortage in key specialty areas. DVHA has chosen to monitor 5 key groups with dwindling provider counts in order to work with multi agencies to address issue proactively: behavior and mental health and substance abuse providers, cardiologists, dentists, pharmacies, and primary care providers (PCPs).
Vermont has been designated a Dental Care Health Professional Shortage Area (HPSAs). HPSAs are geographic areas where the ratio of the population to the providers - measured in full time equivalents, or FTE - is high enough for the Health Resources and Services Administration (HRSA) to designate the area as having a greater need for services. This allows providers working in those areas to access benefits and incentives such as bonus payments for Medicare services, National Health Service Corps (NHSC), State Loan Repayment Program (SLRP), and the J-1 Visa waiver program. These benefits are intended to steer providers to underserved areas. HPSAs are also awarded to safety net providers including Federally Qualified Health Centers and Rural Health Clinics.
Many Dentist in Vermont have stopped accepting new Medicaid patients and many Dentists are nearing retirement age. Per the Vermont Dental Society in the past several years there have been as many as 18 dentist retire or move elsewhere. Currently the average dentist provides 31 hours per week of patient care. 95% accepted new non-Medicaid patients, 65% accepted new Medicaid patients. Orleans, Windham and Windsor Counties have lost FTEs since 2005. To address this problem, the state's dental community has come up with an ambitious approach to replace the dentists who leave or retire (see Strategy note below).
The average wait time as a new Medicaid patient to see a dentist is often 90-120 days. Per the Affordable Care Act, Vermonters have increased access to insurance for dental services, including Medicaid, but many dentists do not accept new Medicaid patients. This is predominantly due to the fact that the reimbursement rates are too low. It’s also hard to recruit new dentists to rural areas. We have recently started to enroll Dental Hygienists; we currently have 6 as of August 2019. Please also see the Strategy note below about dental "therapists".
The American Dental Society suggests that there should be 1 Dentist to every 1500 members in a 60 miles radius. In many areas of Vermont that is not feasible or if the dentist exists it remains a long wait to see the dentist.
In order to address this situation Provider Member Relations is doing targeted outreach in collaboration with the Vermont Dental Society to engage Dental providers who currently do not participate with Medicaid or have a very low volume of Medicaid members.
Last updated: 10/15/2020