Delta Dental of Rhode Island’s new student loan repayment program has stirred up ongoing debates over the causes of a dentist shortage in the Ocean State.
The loan repayment program, administered by the Rhode Island Foundation and funded with $5 million from Delta Dental of Rhode Island’s reserve funds, will provide up to 10 eligible Rhode Island dentists with up to $20,000 toward student loan payments per year for no more than three years.
The aim is to attract and retain more Rhode Island-based dentists, according to the dental insurer. But some say it doesn’t solve the problem of too few dentists setting up shop in Rhode Island.
The loan repayment program is a “Band-Aid solution to a chainsaw wound” that the insurer created, said Dr. Andrew Gazerro, former president of the Rhode Island Dental Association and chair of the group’s Council on Dental Benefits.
Delta Dental’s lack of reimbursement rate increases over the past few decades has contributed to dentists practicing in neighboring states where they can get paid more for services, Gazerro says.
“[Delta Dental] really failed us,” he said.
Fotini Dionisopoulos, president of the Rhode Island Dental Association, says some of the 750 dentists in the state are so overbooked that they turn away new patients. And while she acknowledges that loan repayment can help, it is only applicable to a small number of dentists.
“If Delta had just kept up with the times and reimbursed fairly, I don’t think we’d be in this massive crisis,” Dionisopoulos said.
Reimbursement rates for dentists in Massachusetts and Connecticut are 30% – and in some cases up to 50% – higher on average than they are in Rhode Island, Gazerro says.
From 2008 to 2022, Delta Dental of Rhode Island’s reimbursement for many procedures remained the same, according to data provided by Gazerro. For example, from 2008 to 2022, the insurer paid out $70 for an adult cleaning while the procedure cost dentists on average $105 in 2019.
By the end of 2024, Delta raised that reimbursement to $76, but accounting for inflation, dentists would have to receive $93 to match the rate in 2008, Gazerro says.
But Delta Dental maintains that it made “broad-based adjustments” to its reimbursement rates in 2022 and 2024, as well as additional increases on certain procedures in 2023.
These changes raised reimbursements by more than 8%, or $6.5 million, for Rhode Island dentists. Also, since 2022, the insurance company has given Rhode Island dentists in its network an extra $12.6 million through special programs that reward quality care and support dental hygienist workforce development.
“We see reimbursements, along with these workforce initiatives and our value-based care program, as being a comprehensive way to make the oral health care workforce and ecosystem in Rhode Island as strong as possible,” said Michelle Muscatello, Delta Dental vice president of communications and public affairs.
Elena Nicolella, CEO and president of the Rhode Island Health Center Association, says student loan repayment programs for other health care professionals have proven effective at attracting and keeping workers.
She says a similar program run by the R.I. Department of Health has helped not only dentists but primary care and behavioral health workers pay off their loans in exchange for a commitment to work in Rhode Island. In the past 10 years, 91% of the recipients have kept working in Rhode Island longer than they are required to, according to program data.
Gazerro says reimbursements need to be raised so they are at least back in line with the rates in 2008.
“Until these changes happen, the [loan repayment] program will do little to address the issue,” he said.
