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ADHA Responds to ADA Reports on the Economic Viability of Mid-level Providers

Posted on August 1, 2012

Chicago, July 31, 2012—The American Dental Hygienists’ Association (ADHA) reviewed the six studies released July 25 by the American Dental Association (ADA) examining the economic viability of mid-level providers in dentistry and finds that the methodology utilized to conduct the study impacts the validity of the conclusions drawn by the research. The research, conducted by ECG Management Consultants, Inc., views the access-to-care crisis through the lens of economic viability and makes assumptions about mid-level providers that may not be accurate.

ADHA advocates for evidence-based strategies that support improved oral health and wellness. The organization’s main concerns with the ADA reports are that: 1) they excluded information about—and from—mid-levels that are currently in practice in favor of projected data about proposed workforce models, and 2) the provider models they included do not accurately describe those proposed in the five states addressed in the study.

The reports considered the financial sustainability of three alternative provider models: the dental health aide therapist (DHAT), the dental therapist (DT), and the advanced dental hygiene practitioner (ADHP). Research was not conducted in Minnesota and Alaska, the only two states where mid-level dental providers are actually currently practicing.

Mid-level providers have been proposed in the states included in ADA’s research (Connecticut, Washington, Vermont, New Hampshire and Kansas), but the reports do not accurately reflect the models being proposed. Kansas and Vermont are each considering a licensed dental hygienist with one additional year of education. Washington State has considered legislation, HB 2226, to establish two providers: “a 2-year educated dental practitioner and a dental hygiene practitioner who is a licensed dental hygienist that has completed a post-baccalaureate advanced dental hygiene therapy education program.”

The access-to-care crisis is bigger than a funding problem and will require the entire dental team working to the extent of their education and skills. ADHA encourages ADA and all stakeholders to engage collaboratively across disciplines to define solutions.