Oakland County Fills A Cavity:Privatizing Dental Work

Oakland County now contracts with private dentists for care of low income adults and children. The contract should save Oakland County $250,000 annually and improve access to service.

Oakland County constituents who are eligible for the County-funded dental program may now brush up on private dental care options in the community. The Oakland County Health Division reorganized its dental service delivery model by contracting with dentists in the community who will provide general dental services to approximately 3,000 low income adults and children who do not qualify for Medicaid or other dental insurance. The goal is to improve accessibility, timeliness, and quality for patients while realizing approximately $250,000 in annual savings.

Oakland County constituents who are eligible for the County-funded dental program may now brush up on private dental care options in the community.

Eligible patients will receive the same services that were provided previously through County-operated clinics: routine oral examinations, cleaning, and other selected dental procedures which include emergency care for pain and swelling, tooth extraction, and some surgical procedures. However, private dental providers in the community, rather than from the County clinic, will now provide these services.

The Oakland County Health Division continues to process applications, determine eligibility for the program, function as gatekeeper, and coordinate between the patient and dental provider. Once the patient is determined to be eligible for the program, then he or she can choose to receive service from among six different locations that offer expanded operating hours, allowing greater flexibility in scheduling and more timely delivery of service.

The contracted dental providers determine a treatment plan for each client and are reimbursed by the County on a discounted fee-for-service basis. County-funded patients can expect to receive the same quality of care that the dentist provides to those who have insurance or are self-funded. Once treatment is complete, patients may choose to continue with the same dentist even though they may no longer be eligible for County funding. The County- operated clinic did not provide dental service to those with insurance or who were self-funded, therefore, patients could not continue to receive dental services from the County clinics if they were no longer eligible for the program.

In addition to improved accessibility and quality, the impetus for reorganizing the dental program is the quarter-million-dollar annual savings that will be achieved while increasing the number of people served.

This is just one of several Oakland County services that have been reorganized since implementation of a management incentive program initiated by L. Brooks Patterson in his first term as Oakland County Executive. The incentive program was designed to encourage cost reductions and increase the productivity and economic delivery of public services. As an economic incentive, the savings are shared between the County’s General Fund and divisions that implement cost-saving programs. Over the long term, most of the savings will be returned to the County’s General Fund for general use.

Privatization opponents often treat public-private contracting op-portunities as if they were root canals. Experience in every type of privatization indicates such contracts may be a painless alternative to the status quo.