Medical blog

Tenet 4Q Loss Narrows On Higher Prices; Sees More Red Ink

admin — Tue, 24 Feb 2009 11:24:34 +0000

Tenet Healthcare Corp.’s
(THC) fourth-quarter loss narrowed as the hospital
operator saw improved results amid higher prices.
The company also projected a 2009 loss bigger than expectations,
, according to
Thomson Reuters. Revenue is seen rising to
$9 billion to $9.2 billion
, in line
with estimates, with admissions growth of as much as 1%. Last year’s admissions
increase was 1.2%.
Tenet, which has been struggling to gain its footing after settling government
probes in 2006 over past pricing plans, has changed management, shed hospitals
and made improvements that earned it good-quality ratings from the Department of
Health and Human Services. Still, it faces high supply costs, delays in key
asset sales and high debt levels.
, or
a share, compared with a
year-earlier net loss of
, or
a share. The latest quarter
included a
write-down from the sale two weeks ago of facilities at
the University of Southern California.
Revenue increased 5.7% to
$2.2 billion
.
$2.21 billion
.
Hospitals have struggled for years with tepid volumes of commercially insured
patients and large numbers of uninsured patients who can’t pay their medical
bills. Now, the credit crisis has prompted many hospitals to delay capital
spending and the recession threatens to further erode business.
Same-hospital adjusted earnings before interest, taxes, depreciation and
amortization, the industry benchmark used to track the financial performance of
those hospitals under a company’s wing for more than a year, climbed 27%.
Same-hospital admissions edged down 0.2%, as more-profitable commercial
managed-care admissions fell 3% and government managed-care admissions increased
10.1%. But inpatient revenue per admission increased 3.6%, with the increase for
outpatients at 7%.
The company’s bad debt expense increased 23%, hurt in part by a decline in its
self-pay collection rate. There is concern that the weak economy, including job
losses in particular, will lead to more uninsured patients, uncompensated care
and bad debt.
Shares were up 12.2% at
$1.10
a share premarket. The stock has lost more than
three-quarters of its value since August.
, Dow Jones Newswires; 201-938-2310; shirleen.dorman@
dowjones.com
(END) Dow Jones Newswires
02-24-09 0825ET
Copyright (c) 2009 Dow Jones & Company, Inc.

Drug recommended to prevent prostate cancer in some older men

admin — Mon, 23 Feb 2009 04:07:14 +0000

The panel stopped short of recommending that all men take the drug because clinical trials have not yet shown that it reduces deaths.
Prostate cancer is the second-leading cause of cancer deaths among men, behind lung cancer, with 186,000 new cases diagnosed and 28,660 deaths each year.
Finasteride is used in low doses under the brand name Propecia as an anti-balding drug and in higher doses under the name Proscar for shrinking enlarged prostate glands. The dose recommended for cancer prevention is the same dosage used in Proscar.
The drug interferes with the production of male hormones, starving the tumors of fuel they need to grow.
A major clinical trial reported in 2003 showed that finasteride reduced the risk of prostate cancer by about 25% in men who took it, preventing about 15 cases in every 1,000 men. That means 71 men would have to take the drug for seven years to prevent one case, Kramer said.
Another drug in the same family, called dutasteride or Avodart, is thought to be even more potent and is undergoing clinical trials for prevention. It is also recommended in the guideline.
The medical groups did not issue new recommendations after the completion of the 2003 trial because it appeared that finasteride might have been promoting the growth of more aggressive tumors at the expense of those that are more benign.
“Now we know this is not the case,” Jacoub said. Subsequent studies have shown that shrinkage of the prostate caused by finasteride simply made the aggressive tumors more easily discovered.
The drug does have side effects in some men, however, including reduced potency and loss of sexual desire. Those effects can go away after a couple of months. On the other hand, the drug can result in reduced incontinence and fewer urinary problems.
Cost can also be a problem. The pills cost $2 to $3 a day, or about $1,000 per year, and most insurers do not cover them for cancer prevention.
Speaking at the news conference, panel member Dr. Howard Sandler of Cedars-Sinai Medical Center said, “If I tried the medication for a month or two and I got some side effects, then for me personally the benefit wouldn’t be worth the risk.” But if there were no side effects, he added, “I might sleep better at night.”

FDA Allows Brain Implants for Obsessions

admin — Mon, 23 Feb 2009 03:29:08 +0000

Once the electrodes are implanted, clinicians can control how electrical pulses are delivered to the brain using a battery-run, pacemaker-like device outside the body. By trial and error, doctors figure out what patterns of electrical activity are most likely to help patients while producing the fewest side effects.
OCD is a condition that prompts people to have debilitating and recurring thoughts and compulsive behaviors, such as hand-washing. It is an anxiety disorder, and the FDA approval suggests officials believe that deep brain stimulation might help reduce anxiety. The device was approved for use when conventional treatments, such as medications and talk therapy, have not worked.
The FDA action was designated a “humanitarian device exemption,” a regulatory mechanism designed to encourage the development of treatments for disorders that affect fewer than 4,000 people in the United States. Manufacturers do not have to prove that the device helps patients, only that it can be used safely and is likely to be effective. The FDA said it based its decision on a small study that found deep brain stimulation improved the condition of 26 patients with persistent obsessive-compulsive disorder by an average of 40 percent.
The device approved by the FDA is called Reclaim and is manufactured by Medtronic Inc. of Minneapolis.

Even moderate drinking affects women's cancer risk

admin — Sun, 22 Feb 2009 20:27:25 +0000

Drinking just a glass of wine a day increases women’s risk of breast cancer, as well as several other types of the disease, a new study concludes. The research, carried out among more than a million UK women, says that alcohol accounts for 5,000 cases of breast cancer every year.
What do we know already?
Many of us enjoy relaxing with a glass of wine at the end of the day. But it’s an unpalatable fact that alcohol can damage your health, especially when you look at alcohol’s links to some types of cancer. It’s easy to dismiss these stories as health scares, only relevant to heavy drinkers. But evidence is mounting that even moderate drinkers have an increased cancer risk.
Now researchers have examined the results from a very big study of women aged around 55, to see exactly how the amount of alcohol they drank related to their risk of getting different types of cancer. The women were recruited when they attended breast cancer screening and followed for the next 7 to 8 years, to see if they were diagnosed with any type of cancer.
What does the new study say?
Compared to women who said they drank only 1 or 2 units of alcohol a week, women who regularly drank the equivalent of 1 unit a day had an increased risk of getting seven types of cancer: breast, liver, rectum (part of the bowel), mouth, pharynx (a space at the back of the mouth), oesophagus (the tube that takes food from the mouth to the stomach) and larynx (voicebox).
The risk was most increased for breast cancer. In developed countries like the UK, the chance of having had breast cancer by the age of 75 is 9.5 in 100. According to the study, for every extra daily unit of alcohol (over 2 a week), that risk increases by 1.1 per 100. So if you had a roughly 9.5 percent chance of getting breast cancer by the age of 75, but you drank one glass of wine a day, that risk would go up to 10.6 percent. If you drank two glasses of wine a day, that would increase to 11.7 percent.
These might sound like quite small increases in risk. But because many women drink alcohol at these sorts of levels, it means a lot of women are affected overall. The researchers estimate that alcohol accounts for 11 percent of all breast cancers in the UK. That means that every year, 5,000 women get breast cancer who wouldn’t have got it without drinking alcohol.
The risk for cancers of the mouth, oesophagus, pharynx and larynx only increased for women who also smoked. Researchers think that alcohol may dissolve some of the toxins in cigarette smoke, making drinking and smoking together more risky than doing either alone. There was no increased risk of these cancers for women who drank alcohol but didn’t smoke.
The increased risks for rectum and liver cancer were relatively small, with an increased risk of 1 per 1000 and 0.7 per 1000 respectively.
Most of the women in the study were moderate drinkers. A quarter didn’t drink at all, and of those who drank, only 2 percent drank more than 21 units a week. The average woman in the study who drank alcohol had 7 units a week, or about one drink a day. That reflects previous studies of women in this age group (the average age was 55 at the start of the study).
How reliable are the findings?
The findings are likely to be fairly reliable. The study followed 1.28 million women, for an average 7 years. The women filled in questionnaires at the start of the study, and then again 3 years later, saying how much alcohol they drank. The researchers were also able to take account of other things that affect women’s cancer risk, such as whether they’d taken the contraceptive pill, HRT, whether they smoked or took exercise, and how much they weighed.
The researchers didn’t use the women who drank no alcohol at all as their comparison group. That’s because women who don’t drink at all may have quit alcohol because of serious health problems. So they’re not a healthy group to compare to. Instead, the researchers used women who drank only one or two alcoholic drinks a week as their comparison group. That’s likely to make the results more reliable.
Where does the study come from?
The study was done by the Cancer Epidemiology Unit at the University of Oxford. It was published in the Journal of the National Cancer Institute and published by Oxford University Press. It was funded by Cancer Research UK, the UK Medical Research Council, and the NHS breast screening programme.
What does this mean for me?
Just about everything we do has risks. We can’t avoid risks altogether, but knowing about them can help us make decisions we are comfortable with. It’s been clear for some time that alcohol is a factor in women’s risk of getting cancer, especially breast cancer. This latest study puts some figures on that increased risk. You may find that this helps you decide whether you are happy with the amount of alcohol you drink.
What should I do now?
It helps to know how much you’re drinking. One unit is 10 millilitres (ml) or 8 grams of pure alcohol, which is the amount of pure alcohol in a 25 ml single measure of spirits (ABV 40%), a third of a pint of beer (ABV 5-6%) or half a standard (175 ml) glass of red wine (ABV 12%).
The government’s recommendations are not to drink more than 2 to 3 units a day for women or 3 to 4 units a day for men.
Allen NE, Beral V, Casabonne D, et al. Moderate alcohol intake and cancer incidence in women. Journal of the National Cancer Institute. 2009; 101: 296-305.

Sebelius: No talks with Obama about health post

admin — Sat, 21 Feb 2009 06:24:55 +0000

WASHINGTON (AP) — Kansas Gov. Kathleen Sebelius says she has had no conversations with President Barack Obama about possibly joining his Cabinet as health secretary.
Sebelius (seh-BEEL’-yuhs) was in Washington on Sunday for the winter meetings of the National Governors Association.
Administration officials have said she is near the top of the list of people being considered to run the Health and Human Service Department. But Sebelius tells The Associated Press that “there’s really nothing to tell” about the prospects of her getting the job.
The two-term Democratic governor also is deflecting questions about whether she’ll run for the Senate next year.

Hospital president named Partners CEO

admin — Sat, 21 Feb 2009 02:12:06 +0000

Dr. Gary L. Gottlieb, the president of Brigham and Women’s Hospital, will become chief executive of Partners HealthCare System Inc. at the end of the year, when Dr. James J. Mongan retires from the position.
Partners’ board of directors yesterday unanimously selected Gottlieb, 53, ending five months of speculation. In September, Partners said Mongan would retire at the end of 2009 and named Gottlieb and three other system executives as finalists for his job. A search committee also evaluated outside candidates.
In an interview, Gottlieb said he was “ecstatic.”
“Being a physician is an enormous privilege, and in being a hospital manager, the size of the opportunity grows,” he said. “In the role that I have at the Brigham, I’m facilitating the work of many people who are more talented than I am. As the head of Partners, that opportunity multiplies.”
The post is one of the best-paid and most visible jobs in medicine in the country. Mongan, 67, earned about $2 million in the year ended Sept. 30, 2007, the most recent for which compensation has been reported.
Mongan, former president of Massachusetts General Hospital – another Partners hospital – became chief executive of Partners in 2003. Since then, the company has grown significantly and adopted electronic medical records for its doctors. It is widely seen as one of the most successful “integrated medical systems,” meaning a network that can provide many types of treatment, not just hospital care.
Mongan has also played a public role guiding healthcare policy in the state and nationally. He helped craft the Massachusetts healthcare reform law that has extended medical coverage to more than 400,000 residents, and has played a prominent role in policy debates in Washington, D.C. When he retires, he will also step down from Partners’ board of directors.
Jack Connors Jr., the chairman of the Partners board, said, “The four inside candidates were each superior to the outside candidates. We’ve got some great bench strength. We’re hopeful the three alternate candidates stay with us as well.”
Many members of the healthcare community favored Gottlieb because he came from Brigham and Women’s. Mongan and his predecessor as Partners chief executive, Dr. Samuel Thier, both came from Mass. General, the other founding facility of the Partners group.
While Gottlieb’s selection “creates a certain symmetry,” Connors said, it wasn’t a factor in the search.
The decision comes at a crucial time for Partners. The system, formed in 1994 by the Brigham and Mass. General, has grown to become a potent force throughout healthcare in Eastern Massachusetts. It provides about one-quarter of inpatient treatment in Greater Boston, and has expanded to include Newton-Wellesley Hospital, North Shore Medical Center in Salem, Faulkner Hospital in Boston, and McLean Hospital in Belmont.
Partners is the largest private employer in the state, with 50,000 employees. Its growth has spurred complaints from community hospitals that Partners has used its financial resources to expand aggressively and lure patients for lucrative procedures, leaving the smaller hospitals to treat patients with government health insurance and conditions that do not pay as well.
Meantime, Partners is facing an inquiry by Attorney General Martha Coakley. Last month, Coakley issued civil requests for information to Partners and Blue Cross and Blue Shield of Massachusetts following a Globe Spotlight story in December that showed the two healthcare giants had entered into a contract that was potentially anticompetitive.
Gottlieb, a psychiatrist, had a national reputation for his work in geriatric mental health when he was recruited by Partners in 1998 from the University of Pennsylvania. He became head of Partners’ psychiatric services, and served as interim head of North Shore Medical Center.
He became president of Brigham and Women’s in 1992. He has also served as cochair of the Mayor’s Task Force to Eliminate Health Disparities, and is the chairman of the Private Industry Council, a civic group that seeks to build the healthcare workforce for Boston.
“I hope I’ve made the Brigham more effective in delivering care, created a more gifted workforce that’s better enabled to do their jobs, and made the Brigham more of a corporate citizen in our communities,” Gottlieb said.
He acknowledged that the rising costs of healthcare are a challenge, saying preventive care, and improved access to treatment that can eliminate the need for costly emergency care can help slow increases.
“Improved access to care is critical,” Gottlieb said.
.

Obama calls for health-care reform in 2009

admin — Thu, 19 Feb 2009 18:42:50 +0000

– President Obama pledged Tuesday night to cure Americans from what he called “the crushing cost of health costs,” saying the country could not afford to put health-care reform on hold.
“This is a cost that now causes a bankruptcy in America every 30 seconds. By the end of the year, it could cause 1.5 million Americans to lose their homes,” Obama said in his speech to a joint session of Congress.
Obama pointed to the increasing number of uninsured and rapidly rising health-care premiums, which he said was one reason small business closed their doors and corporations moved overseas.
Obama’s prescription for health-care reform included making “the largest investment ever” in preventive care, rooting out Medicare fraud and investing in electronic health records and new technology in an effort to reduce errors, bring down costs, ensure privacy and save lives.
“I suffer no illusions that this will be an easy process,” the president said, adding that he was scheduling a gathering next week of “businesses and workers, doctors and health-care providers, Democrats and Republicans.”
“The cost of health care has weighed down our economy and our conscience long enough. So let there be no doubt, health-care reform cannot wait, it must not wait and it will not wait another year,” Obama said to a standing ovation.
The president also said Americans would see a cure for cancer “in our time.” Obama’s mother, Ann Dunham, died of ovarian and uterine cancer at 52.
Obama made health-care reform a central theme of his presidential campaign and promised not only to achieve universal health care in his first term, but also to cut the average family’s health care health-care costs by $2,500.
In his speech Tuesday, he placed health-care reform alongside education and energy reforms as central pillars of his recovery plan.
An estimated 45.7 million Americans are uninsured, and for those with coverage, and
have been rising four times faster than wages, Obama said.
The average cost of family health-care coverage more than doubled from 1999 to 2008, from $1,543 to $3,354, according to a report by the Institute on Medicine released Tuesday.
During his speech, Obama touted changes in the health-care system already passed in his month-old administration as part of The American Recovery and Reinvestment Act.
“Already, we have done more to advance the cause of health-care reform in the last 30 days than we have in the last decade,” he said. “When it was days old, this Congress passed a law to provide and protect health insurance for 11 million American children whose parents work full-time.”
Signed into law on February 17, The American Recovery and Reinvestment Act also includes $87 billion to bolster state Medicaid programs and offers a 65 percent subsidy for nine months to help the unemployed pay for their COBRA coverage.
COBRA allows the unemployed to pick up the payments and continue the health insurance coverage they had with their former employer. The subsidy would help an estimated seven million Americans, according to a congressional estimate.
The president’s health-care message was applauded by Ron Pollack, executive director of Families USA, a national organization for health care consumers.
is absolutely correct that the nation’s economy and the federal budget deficit cannot be fixed without meaningful health-care reform,” Pollack said in a statement.

Pedro Espada, John Catsimatidis trade barbs

admin — Thu, 19 Feb 2009 12:43:23 +0000

Pedro Espada, John Catsimatidis trade barbs
Friday, February 20th 2009, 2:09 AM
state senator and a billionaire mayoral candidate traded charges Thursday that one’s a miser and the other is stiffing him on the rent.
And no, the billionaire is not
.
State Sen.
, who runs the
Healthcare Network, said he’s being forced to close one of his longtime facilities today because it can no longer meet “the astronomical rent demands” of its landlord, billionaire businessman and mayoral wannabe
.
But Catsimatidis promptly fired back through a spokesman that Espada has long been a problem tenant, and is skipping out while still owing him rent.
The two have been locked in a landlord-tenant dispute over the Jessica Guzman Medical Center at 616 Castle Hill Ave.
After a lengthy dispute over what the rent should be, the two signed a new five-year lease in January 2008.
Espada called it “way above market value” at the time, but decided, as he put it, “to give in to the Grinch and give him his money.”
Espada contended that an independent appraisal put the market rate of the property at $25 per square foot. Catsimatidis called for – and later got – $37.50 a square foot – or $11,375 a month.
But Espada sent Catsimatidis a letter of termination Sept. 30, and hasn’t paid rent since.
“John Catsimatidis believes all New Yorkers deserve good health care,” said his spokesman,
. “We have worked diligently with Soundview to achieve that goal. Frankly, we’re surprised they terminated the lease.”
The not-for-profit community health facility was named in memory of the murdered youngster whose disappearance in 1990 mobilized one of the largest law enforcement searches in city history. Her killer is now serving a life term.
“It’s a sad day because the Jessica Guzman Medical Center, in addition to providing high-quality health care, became a beacon of hope and healing amidst the tragic death of a neighborhood child,” said
, who serves as medical director of the Soundview Healthcare Network.
, the main facility in the Soundview Healthcare Network, at 731 White Plains Road, just three blocks from the Jessica Guzman Medical Center.
Collymore said that seniors can make special arrangements by calling Soundview Health Center at (718) 589-2232.
“The most important thing for our patients to know is, there will be no interruption in service. The continuity of their care will be seamless.”
‘Frankly,
we’re surprised they terminated the lease.’

City Health Center great resource for families

admin — Thu, 19 Feb 2009 09:27:38 +0000

Established in October, the Gloucester Family Health Center at 302 Washington St. offers a broad scope of services uniquely tailored to care for the local community.
The new Gloucester center is the fourth site of its parent company, North Shore Community Health Inc., which operates three other locations in Salem and Peabody. The non-profit organizations receive both Medicaid and Medicare funding and are overseen by a board of directors, half of whom are consumers. “It’s a beautiful facility,” says Dr. Robert Hendershott, Ed. D. who oversees all four practices. “It’s the kind of spot people can come to and feel comfortable.”
The Cape Ann site has become one of a network of 1,200 Federally-qualified health centers that serve up to 18 million persons throughout the country. These companies have been designated by the government as “their healthcare system” and are situated in underserved and rural regions, Hendershott said. He added that one of the first centers in the country was founded in nearby Boston, and that President John F. Kennedy signed in the first Family Health Center that served migrant workers.
Locally, “there has been a need in Gloucester for a long time,” Hendershott continued. “There’s a large uninsured population that’s medically underserved in this area. We are trying to grow this system and become a more vital organization.” Family Nurse Practitioner Christine Malagrida agrees “the Center has been much anticipated and we are here now to serve anyone.”
The Center cares for persons of all ages and incomes, from newborns to elders, and accepts most insurance policies, including MassHealth, Health Safety Net and CommonHealth products. In addition, the Center has benefit specialists on staff to guide uninsured persons through the application process for these programs. “Our financial counseling is one thing that makes us unique,” Malagrida said.
Another special service that reflects the Center’s commitment to its new community is that it is “linguistically competent,” Malagrida pointed out. Most of the staff is multi-lingual, and can converse in English, Portuguese and Spanish, so there are no language difficulties to overcome.
The Center focuses on primary care, and the supervising physician and nurse practitioner are skilled in family medicine. The facility also hosts a full service dental clinic. “It is huge for any community to have more dental services,” Malagrida said.
Another distinctive facet of care is the Center pilot program that integrates primary care and behavioral health, which encompasses mental health and substance abuse concerns. Behavioral Health Consultant Lisa Schott, LICSW, works exclusively with Center clients and provides immediate, on-site support, which eliminates any waiting periods for appointments and transportation barriers. “It’s a great resource,” Malagrida said. “We’re bringing her in to primary care visits right when the patient is being seen to address behavioral health issues of our clients.” She said the patients have been very receptive to this service, because “in general in primary care, behavioral health issues account for a large number of visits.” Anxiety, depression and sleep disorders are the most common complaints, she related.
“We are very mission oriented, work hard, and have a really good staff that really wants to serve the people,” Hendershott said. He said that the community and local partners such as Northeast Health Systems, the Gloucester Health Department, Health and Education Services and the Mayor’s office have been very supportive of the Center and put in a great effort to help launch the project. An open house was held last fall and was well attended by local citizens and professional partners, he said.
The Center hopes to expand the availability of primary care throughout Gloucester and contribute to better health region wide. It offers same day sick appointments on a walk-in basis, but the staff also emphasize that the Center will strive to serve as a “medical home” for patients. “When you come here, you are choosing us to be your primary care provider,” Malagrida says. The Center offers 24 hour call service as well.
The group works with area pharmacies for prescription needs, and has already cemented a partnership with Eaton Apothecary to offer low-cost prescriptions to those who subscribe to Health Safety Net. The Center hosts a laboratory for blood work, and also works with next door neighbor Addison Gilbert Hospital to process x-rays and other diagnostic tests.
“We’re very proud of our facility and those who work there,” Hendershott said. “We are very excited and will continue to grow and expand.” For an appointment at the Gloucester Family Health Center, please call 978-282-8899.
This article is part of a regular health education series provided by the Gloucester Health Department and Addison Gilbert Hospital.

Care in Maryland is improving, but loss of jobs, health benefits …

admin — Wed, 18 Feb 2009 10:15:34 +0000

With February’s National Children’s Dental Health Month upon them, academic, industry and government leaders can point to improvements. They formed a Dental Action Committee that has won aid for local health centers; streamlined the Medicaid program; and sent hygienists into the community to provide screenings. They’ve been gaining commitments from dentists to treat poor children. They worry, however, that the bad economy will set back efforts and that there will be less money for care at a time when people are losing their jobs and private health care.
“The problem is huge,” said Rosemary Fetter, executive director of the Baltimore dental museum, where about 60 kids got some hands-on education as well as dental screenings this month as part of an annual event. “Problems with teeth keep kids out of school, some statistics say, more than anything else.”
Student volunteers from the nearby University of Maryland Dental School said the children’s mouths didn’t look too bad during the recent visit. Many had been to dentists, as evidenced by work done on their baby teeth. The volunteers also thought they were keeping the kids’ attention during the oral-hygiene lessons by using props and computers.
“This is much better than a video,” said Gloria Gillian, one of the kindergarteners’ teachers. “It’ll stick with them. They’ll go home and tell their parents. And when they’re in the store, they’ll remind them to get floss.”
Kiniya Coleman, who was missing her front teeth, said she’d brush the ones she has. Classmate Nia Thompson said her mother had already taught her “everything” about brushing.
“Up and down, up and down,” she said. Then, while demonstrating on those giant teeth, she told her classmates, “You got to get in the back.”
Such events are also reaching children who aren’t seeing dentists regularly, said Dr. Marc Nuger, president of the Maryland State Dental Association. And Nuger and others on the Dental Action Committee, including Dr. Norman Tinanoff, chair of the UM Dental School’s Department of Health Promotion and Policy, said they can point to other successes:
•The state was able to simplify its Medicaid system by reducing the number of companies serving patients to one from seven or eight. Patients and dentists will call only one number as of July 1.
•Reimbursements for dentists taking Medicaid patients are increasing, which is luring more professionals to treat the poor. The first raise came in July, and two more are planned, though the recession is causing a delay.
•State health workers received an extra $1.5 million to bolster care in community centers.
•Dental hygienists received permission to screen more children in public health settings.
•Dentists were offered training in pediatric dentistry so they could more confidently treat children.
•Doctors who treat Medicaid patients will soon be compensated for providing fluoride treatments in their offices after they complete a training course.
Nuger said the changes, including the single-payer system for Medicaid, have already netted almost 100 new dentists in the Medicaid system in the past two years, bringing the total to about 400. The group is looking for about 200 more. There are about 4,000 dentists in Maryland.
“The new system is going to be a big plus,” Nuger said. “There are some 400,000 on the Medicaid roles in Maryland, and we’d like to get more to see a dentist regularly.”
Nationwide, despite fluoridated water and toothpaste and increased dental visits, dental disease and cavities among preschoolers are rising, largely among poor children, according to data from the American Dental Association and the National Institute of Dental and Craniofacial Research.