Looking for the patient site or careers site? Visit mykoolsmiles.com or koolsmilesjobs.com | FAQs | Contact Us

Laffer: Bridging the dental divide for Texas children on Medicaid

Published by the Austin American-Statesman

Back in 2012, I delved into a topic of utmost importance and surprising depth: children’s dental health. For years, many dentists chose not to treat Medicaid patients. From an economic point of view, it was really no surprise; providers willing to treat the state’s most vulnerable patients faced prohibitively low reimbursement rates, while also being asked to bear prohibitively high administrative costs. As a result, many low-income children simply didn’t receive the dental care they needed.

Given the lifelong health consequences of poor dental health — as well as the rising costs associated with expensive emergency room visits for untreated tooth decay – Texas decided to act in 2007, raising Medicaid reimbursement rates in order to incentivize dentists to serve Medicaid patients. While many dentists continued to avoid low-income populations, something incredible took hold. That is, American entrepreneurs provided a free-market solution to a public health problem.

Specifically, dental practices supported by Dental Service Organizations (DSOs) began opening their doors to Medicaid patients. They were able to do so because DSOs tapped into economies …

Read More

Smears Against ‘Corporate Dentistry’ Are Not Based In Fact

Published by Forbes

There is an increasingly large body of evidence demonstrating that dental hygiene is important to one’s overall health, which means ensuring access to dental care at prices consumers can afford is critical to public health. This makes it all the more troubling to see Dr. Bernard Larson, the incoming president of the Washington State Dental Association, take to the pages of the Seattle Times to publicly attack and spread misinformation about organizations that are helping to reduce costs and expand access to dental care in Washington State.

For over three decades, dentists have been able to operate more efficiently, bring down costs, and expand access to care by employing a business model that has been used for a long time by a number of other medical professionals, such as oncologists, emergency room managers, optometrists and other doctors. Dentists have accomplished this by contracting with companies, referred to as Dental Support Organizations (DSOs). DSOs handle non-clinical, administrative functions, such as property management, bookkeeping, payroll and marketing. There is now legislation pending in the Washington State Legislature, …

Read More

Competition’s latest battlefield – the practice of dentistry

Published by The Hill Congress Blog

One of the major, 20th-century body blows to free enterprise was delivered by the U.S. Supreme Court in 1955, via a decision against Oklahoma opticians in a case brought by rival optometrists and ophthalmologists. The latter had convinced the state legislature to pass a law limiting the ability of opticians to provide consumers with corrective lenses. Liberal Associate Justice William O. Douglas wrote for the High Court that state legislators no longer would need to provide a clear, or even a rational basis for restricting one class of business or profession in order to benefit another.

The reasoning in that decision (Williamson v. Lee Optical ) remains to this day one of the favored legal shields with which established business and professional interests protect themselves from real or perceived rivals seeking to enhance competition or lower costs. The 60-year old decision came to my mind recently as I reflected on a pair of articles relating to the practice of dentistry in my home state of Georgia and nationally.

The first catalyst for jogging …

Read More

Congress: Future smiles depend on permanent CHIP funding

Published by The Hill Congress Blog

A year ago this month, anxious parents and children’s advocates awaited a decision by Congress regarding the future of one of the nation’s most successful health programs. Funding for the Children’s Health Insurance Program (CHIP) – which has provided health coverage for millions of low-income children since 1997 – was in jeopardy of expiring, leaving more than eight million children in a dangerous gray area.

Without CHIP, those children who were ineligible for Medicaid but whose families could not afford private insurance, would be expected to obtain coverage through their state’s Health Insurance Marketplace. But some marketplace plans failed to offer affordable, comprehensive coverage for specific services, like dental healthcare, for children.

Fortunately, Congress did elect last year to reauthorize CHIP funding for another two years. It was a good decision for the health of our nation’s kids and surprisingly prescient, considering findings released by the Centers for Medicare and Medicaid Services (CMS) in November. According to the report, coverage offered by plans in the Marketplaces simply don’t measure up to what’s offered …

Read More

We Can and Must Improve Access to Dental Care for Minority Children

Published by Real Clear Health

February is National Children’s Dental Health Month, a much needed opportunity to focus on the issues facing the oral health of kids in the U.S. today. According to the California Society of Pediatric Dentistry, “Tooth decay is the number one chronic health problem of children.” Minority children are particularly hard hit. African Americans, Hispanics and American Indians generally have the worst oral health among all racial or ethnic groups in America. The ill effects of these tooth decay issues are broad ranging: missed school days, impeded speaking and learning development, low self-esteem and generally poor social development.

The National Hispanic Medical Association noted in a July 2015 study that with more than one third of all Hispanics covered under government health insurance, it is unsurprising that Medicaid is often regarded as a lifeline to health care treatment within minority communities. Shortcomings within the various government insurance programs are too numerous to list while private sector solutions to public sector problems are too few.

Dentistry has traditionally been a cottage industry – a …

Read More

Report: Kool Smiles protocol could save states money

Published by Dr. Bicuspid

A recent report issued by the dental service organization Kool Smiles claims that state dental programs could save millions and provide oral care to more children if Medicaid dental providers used the company’s care protocol and utilization rates.

Medicaid dental programs in seven states could save more than $550 million annually and provide Medicaid dental care to an additional 1.9 million children if the organization’s practices were adopted, according to the report.

The report was paid for by the Benevis Foundation, which was hired by Kool Smiles to provide nonclinical practice support services. Kool Smiles has more than 120 affiliated dental practices in 15 states and the District of Columbia.

The analysis was done by Dobson DaVanzo & Associates using Medicaid claims data for nine states, seven of which were included in the analysis, from 2011 to 2015 and represents utilization and Medicaid expenditures from 164 Kool Smiles dentists and 8,077 non-Kool Smiles dentists.

The analysis found that Kool Smiles dentists performed more conservative, cost-effective care when compared with other Medicaid …

Read More

DSOs Illustrate How the Private Sector Can Solve Public Health Problems

Published by Forbes

Delusions that increased government control will heal what ails the U.S. health care system continue to fester. Private dental organizations are illustrating that it is private sector innovations, not increased government regulations, which have the power to improve the U.S. health care system.

Poor dental care is linked to higher risks of cardiovascular disease, increased incidence of infections, and makes managing diabetes (a growing chronic problem in the U.S.) even more difficult.

Despite the importance of good dental care, lower income children have appallingly low access.  According to the Pew Charitable Trust, “the latest data from 2014 show that more than 18 million low-income children went without [dental] care.”  And, lack of access to dental services is associated with lower overall oral health.

According to the Kaiser Family Foundation, tooth decay still remains one of the most common chronic diseases among children aged 6-18, especially children from lower-income families.  The broader consequences can be significant.

A 2011 Reuters story reported that “in the U.S., it’s estimated that up to 11 percent of 2-year-olds and 44 percent …

Read More

Making a difference in dental care

Published by One News Now

A new study compares pediatric dental practices across Medicaid providers and states.

February is National Children’s Dental Health Month, and the Benevis Foundation, a nonprofit aiming to improve dental health access and outcomes among underserved pediatric patient populations, has released a report that compares the dental utilization and monthly Medicaid expenditures for patients who received care by a Kool Smiles provider to non-Kool Smiles providers.

Kool Smiles is a client of Benevis, a comprehensive practice services company and parent organization of the Benevis Foundation.

“The headline is really that Kool Smiles dentists do about 15 percent fewer services overall and charge Medicaid really an astounding 33 percent less than their peers,” reports Geoffrey Freeman, co-founder of the Benevis Foundation. “[That] is really groundbreaking, because it implies that if states had Kool Smiles dentists doing all of their Medicaid treatment, they could really save hundreds of millions of dollars annually.”

But Freeman goes on to explain that providers like Kool Smiles do not do all the treatments because …

Read More

Bridging The Great Dental Divide–Cost-Effectively

Published by Health News Digest

A few years ago, this column examined the problem of getting much-needed dental care to lower income Americans.  The so-called “Great Dental Divide” was exemplified–tragically–in the case of a 12-year-old boy from Prince George’s County, MD, who literally died from lack of basic dental care in 2007.  An untreated abscessed tooth eventually led to a fatal brain infection.

As if that weren’t bad enough, the devastating failures of the system were melodramatically underscored, in that the unavailable $80 tooth extraction directly caused the more than $250,000 unsuccessful acute effort to save his life.  To be sure, this tragedy did lead to a guaranteed dental benefit in the Children’s Health Insurance Program (CHIP) portion of Medicaid.

That’s all very well, but care still has to be brought to these Medicaid patients.  Thus, the emergence of Dental Management Service Organizations (DMSOs) and Dental Service Organizations (DSOs).  Another term you might see is Dental Practice Management Companies (DPMCs).   Broad brush, they all refer to “corporate dentistry.”  Usually, a DSO has internal management, while …

Read More

New study: Medicaid dental programs in 7 states could save $550 million annually through adoption of a DSO model

Published by Dentistry IQ

According to the study, Kool Smiles dental practices are low-cost, conservative providers of Medicaid dental care compared to other Medicaid dental providers 

The Benevis Foundation has announced the release of a multi-year, multi-state study by Dobson DaVanzo & Associates examining Medicaid dental utilization trends and expenditures in seven states, using publicly available Medicaid dental claims. The study, released during National Children’s Dental Health Month, found that providers from Kool Smiles, a national dental practice serving pediatric Medicaid patients, performed more conservative, cost-effective care when compared to other Medicaid dental providers in Texas, Indiana, Virginia, Georgia, Mississippi, Louisiana, and South Carolina.

The analysis of Medicaid claims data supports recent research indicating that the dental service organization (DSO) practice support model is effectively narrowing the gap in access to quality dental care for low-income children and families.

Using publicly available Medicaid data from 2011 to 2015, the study found:

Kool Smiles dental providers performed 15% fewer services overall, including 40% fewer extractions and 39% fewer pulpotomies. As a result of lower utilization rates, Kool Smiles patients had an overall average monthly Medicaid expenditure that was 33% lower than non-Kool Smiles patients …

Read More