With the closing of Dr. Steven Bailey’s practice, Orcas Island no longer has a dental office that will accept Washington state’s Medicaid program Apple Health.
“There’s a reason offices don’t take it: because there really is almost no reimbursement. By the time the office pays the staff, we’re actually paying out of pocket to have patients in,” said Kathy Wood, a dental hygienist and administrator for her husband Dr. Chris Wood, DDS, who purchased the business from the Baileys. “For us, and for 90 percent of dental offices, you can’t keep the doors open and be a(n) (Apple Health) provider unless that’s all you’re doing and you’re high volume. We’re not high volume. It’s a small community; it’s a small business.”
The Woods took over the practice on July 1 after Bailey announced he and his family were leaving Orcas. It has been renamed Island House Dental Care. When the metaphorical baton was passed, Chris and his staff decided that they would not be able to continue to accept Apple Health patients and sent out letters to Bailey’s existing Apple Health patients – nearly 300 people. Some frustrated letter recipients have voiced their concerns online and by sending angry letters to the office, Kathy said.
Compared to private insurance, Apple Health, which is for low-income families, pays significantly less. While insurance companies like Delta Dental pay to the tune of approximately $130 for an adult tooth cleaning and oral exam, Apple Health pays approximately $50. A child’s teeth cleaning is typically more expensive than an adult’s appointment. The cost increases drastically if additional dental procedures like cavity fillings and root canals are required.
“(With Apple Health,) we lose approximately $100 per cleaning,” Chris said. “There were over 100 of those cleanings scheduled in the first month or two. So it was an overwhelming thing.”
Kathy explained that between the cost of paying staff and keeping the facility and tools in workable order, being an Apple Health provider would put the clinic in the hole financially.
“First and foremost this is a business, and if you don’t have revenue, the lights aren’t on and you can’t treat people,” she said.
Island House isn’t alone in not taking Apple Health patients. Only one full-time dentist in San Juan County is a provider for state insurance. In Friday Harbor, Dr. Michael T. Horn takes Medicaid patients under the age of 7, but Kathy said she doesn’t think he’s accepting any more patients at this time.
Knowing that there is a need in the community, however, Kathy said the staff in her clinic has volunteered to dedicate four days a year of unpaid dental service to children in the community. For adult patients, the office provides two payment alternatives and is in discussions with the Orcas Island Community Foundation to consider more options.
“Our goal is not to take anything away,” Kathy said. “We’re actually trying to just formulate and reorganize how we can provide care to people in the community who have the most need. We’ve always been committed to that throughout our entire career.”
Since there is a lack of Apple Health dental providers for children, Wood suggests that parents call Playhouse Dental in Anacortes. They can be reached at 360-675-4613.
“What we’re asking about is some patience and maybe give us a call and talk to us about it before jumping to conclusions that we’re just cutting everybody off and don’t want to see you,” Kathy said. “It’s not that we don’t want to see you. We have to find a way to see you and keep the doors open and do it in a productive, healthy, accessible, affordable manner.”