Should Your Practice Take Medi-Cal Patients

Reimbursement is lower than private fees. That is real and pretending otherwise helps nobody. The practices that make it work do it on volume, a schedule built for it and a front desk that stops the leaks, not on goodwill.

The trade. Lower per visit, more predictable demand
Works when. Your chair time would otherwise sit empty
Fails when. You run it exactly like your private schedule
Decide with. Your own numbers over three months

Start With the Real Number

Reimbursement for Medicaid dental is below typical private fees. Any argument for taking it has to start there rather than around it.

The question is not whether the per visit figure is lower. It is whether the visit would have happened at all, and what an empty chair costs you by comparison.

Empty Chairs Are the Comparison That Matters

A practice at full capacity on private fees has an easy answer. Most practices are not at full capacity, and a quiet Tuesday afternoon costs the same in rent and wages whether anyone is in the chair or not.

Filling that time at a lower rate is different from replacing higher paid work with lower paid work. Know which one you are actually proposing.

The Failure Mode Is Running It Unchanged

The offices that regret it usually bolted Medicaid patients onto a schedule designed for something else, then absorbed the extra admin, the eligibility checks and the authorizations with the same staffing.

The ones that make it work build for it. Blocks at specific times, a front desk process for eligibility, somebody who owns authorizations, and realistic appointment lengths.

Cancellations Are a Logistics Problem, Not a Character Problem

Missed appointments run higher, and the reasons are usually transport, work that does not give time off, and childcare. Treating that as a patient failing gets you nowhere.

Reminders that actually reach people, a cancellation list, and candor about which slots suit shift workers fix more of it than a fee ever will.

Try It as a Measurable Experiment

You do not have to decide the whole question at once. Open a limited number of slots, run it for three months, and measure your own numbers.

Chair time used, admin hours added, denial rate, no show rate, and what those slots would otherwise have earned. Then decide with your figures instead of somebody else's.

The Part That Is Not on the Spreadsheet

There is a real shortage of dentists willing to see these patients, and people travel a long way or go without because of it.

That is not a business case and it should not be dressed up as one. It is a reason some practices choose to do it anyway, and it is worth naming plainly rather than hiding inside a financial argument that does not quite hold.

Before You Spend a Dime

Can we limit how many we take?

Many practices do, by opening a set number of slots. Check your obligations under the program and any contract before you cap.

Will it change the character of the practice?

It changes your schedule and your admin more than your clinical work. Plan the schedule and the admin.

What is the single biggest lever?

Eligibility checking on the day. It removes the most common reason for doing work you never get paid for.

Next Problem to Solve

Correct or add your practice