The state has invested significant resources into improving the Medi-Cal Dental program in the past several years and yet the 20-year-old Dental Managed Care pilot continues to trap residents of Sacramento and Los Angeles in a failed system that hinders their access to necessary oral health care. Nearly 1 million residents — 7% of the state’s Medi-Cal beneficiaries — are stuck in this inferior system. It is time to acknowledge that residents of Sacramento and L.A. counties need and deserve access to the same dental benefits available to the rest of the state’s Medi-Cal enrollees.
CDA is calling on the Legislature to support the Newsom administration’s proposal to finally declare this failed pilot over. The data speaks for itself:
Since 2016, the statewide Medi-Cal Dental program has been steadily improving. However, despite significant investment, the DMC plans continue to lag behind the rest of the state in every measurable metric. In 2019, only 40.5% of Sacramento’s children in Medi-Cal made it to a dental visit, a full 10% lower than the statewide average.
DMC plans underperform the rest of the state in every metric used to measure the Medi-Cal Dental program throughout the state.
According to the LAO, per capita spending is 50% higher in DMC compared to fee-for-service. Medi-Cal continues to pay more and get less under dental managed care than in FFS.
Sacramento (mandatory DMC) fails to compare to similarly sized counties and communities. Sacramento ranks 43rd in the state for children’s utilization and is by far the lowest ranking metropolitan county.
L.A. optional dental managed care had a utilization rate that was nine percentage points lower than L.A. fee-for-service for kids in 2019 (52.4% versus 43.6%).