Mosaic Health expansion good for Medicaid, low-income patients

Mosaic Health Utica Dental opened on Parkside Court in late June, expanding access to dental care for Medicaid and low-income patients.

But shifting dental services out of Mosaic Health Utica on Oneida Street, formerly the Utica Community Health Center, also helps Mosaic Health to expand its medical services, said President and CEO Michael Leary. That center, a federally qualified health center, opened in 2010, offering medical and dental care and later adding behavioral health services.

"Our medical and dental services have been at capacity since a year-and-a-half or two-years after we opened," Leary said.

"We have literally hundreds of people on our waiting list," he added. "We're unable to see them now."

The last time he looked at the number, it was 500 names on the list, but the expansion of medical and dental services should help.

"We're seeing folks coming from Herkimer County to our site in Utica," Leary said. "Folks come from as far north as Boonville. They come from Waterville, from all around."

But about half the center's patients are refugees and their families, he said.

"Access (to care) is limited and we're doing everything we can to increase it at every opportunity," Leary said. "It's a challenge, but it's one we're up to."

ACCESS ISSUES

Health care providers are in shorter supply overall upstate than downstate, particularly in rural areas where patients sometimes struggle just to reach a provider – if the provider has appointments open.

In Oneida County, there was one primary care doctor for every 1,340 residents in 2016, according to the 2019 County Health Rankings from the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. That compares to a statewide average of one per 1,200 residents.

But many rural counties have far higher ratios. In Herkimer County, there was one primary care doctor for every 3,480 residents.

The same holds true for dentists. Oneida County had one dentist for every 1,780 residents in 2017 and Herkimer County had one for every 2,830 residents in 2017, according to the rankings. That compares to one dentist per 1,230 residents statewide.

Of course, provider shortages aren't the only thing that prevents access to care. Patients without insurance often can't afford care and even patients with health or dental insurance must find providers who accept their health plans.

For example, in Utica, only one or two private dental practices, the Faxton St. Luke's Healthcare dental residency program and Mosaic Health accept Medicaid for dental care, Leary noted.

"We're the only one, that I'm aware of, in the community that's dedicated to serving Medicaid patients, but also provides sliding-fee discounts for the services that we provide," Leary said. "That can be very meaningful to folks that have financial challenges in getting care."

That sliding fee, by federal rules, only applies to people who earn no more than 200 percent of the federal poverty level. But staff help patients to find insurance plans and other programs that can keep costs down, and works out no-interest payment plans, Leary said.

EFFICIENT WORKFLOW

The health center and the new dental clinic in Utica are part of the Rochester-based nonprofit Mosaic Health, formerly known as Regional Primary Care Network, which also runs a federally qualified health center in Ilion.

The new dental site expands the dental program from five operatories to eight and creates a more efficient workflow that will help it to see even more patients than just the additional space would allow, Leary said. The center is also planning to hire more staff.

"I hope we have several years' growth in front of us," he said. "We're also looking at, as we fill up the schedule, offering additional hours of operation as a way to increase capacity. Perhaps some evening hours and maybe even Saturdays."

Dental services moved to allow medical and behavioral health services to expand and have enough parking, Leary said. "We're going from six exam rooms to 11 medical exam rooms, plus some additional medical capacity. And we're adding consult rooms and conference rooms for behavioral health services," he said.

The first phase of the project, which is being funded by a state and a federal grant, should be completed in August, he said.

Behavioral health services is the one area that is not yet at capacity, Leary said, noting that integrating behavioral health into primary care has proven challenging. Eventually, though, especially as medical services expand, he anticipates the need to hire more behavioral health staff, he said.

Contact reporter Amy Neff Roth at 315-792-5166 or follow her on Twitter (@OD_Roth).

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