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HL20: Jeffrey A. Parker—Making Margin While Serving the Poor

Philip Betbeze, for HealthLeaders Media, December 2, 2013

The idea that Medicaid and the Children's Health Insurance Program don't pay enough is a myth, Parker contends, with evidence to back up the claim. Strangely enough, the organization has succeeded at least in part by driving down dental costs. In fact, the company's average reimbursement per patient has gone from $328 in 2005 to $125 in 2012. Scale has been the key, including electronic health records and digital panoramic x-ray machines. That, and salaried dentists.

"In other words, whatever is state of the art equipment, we have it, and it's paid for, off of primarily Medicaid and CHIP revenues," he says. "We don't rely on cash donations or grants to sustain ourselves. If I can build 14 offices with as good equipment as anyone else, with my major source of income as Medicaid and CHIP, there's enough money if you run it properly."

Good dental health has been cited as a key variable of whether someone is less or more susceptible to future, more serious health challenges, and the focus on prevention resonates in the imperative in all of healthcare to reduce spending and improve care. Parker has had battles with the state dental society for years over protecting their turf. Peace between the two groups has been the rule of late, because even though Sarrell is allowed to see adults and those who are not on Medicaid, the center does not actively recruits these patients.

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