Los Angeles County4,730 enrolled Medi-Cal dentistsCY2024 claims
595 dentists carry half the adult Medi-Cal caseload of LA County’s enrolled dentists.
Medi-Cal dental payments are scheduled to change on July 1, 2027. If dentists leave the program, which dentists leave will matter more than how many. This is a public, reproducible baseline of the network before that date, built only from public state files.
Every enrolled LA dentist, busiest to quietest. Bar height: adult Medi-Cal patients seen in 2024.
- Caseload
- Each dentist’s count of Medi-Cal dental patients in 2024, added up across dentists. It counts all of a dentist’s patients, wherever seen: dentists also listed in another county hold 47.7% of the adult caseload. A patient seen by two dentists counts twice, so this measures dentists’ workload, not a head count of people. Methods & limitations
Half of the adult caseload sits with about one dentist in eight.
Rank all 4,730 enrolled LA dentists from busiest to quietest and add up their 2024 caseloads as you go. If every dentist saw the same number of patients, the curve would follow the diagonal.
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43.7%/63.9%
of adult / child caseload sits with the busiest 10% of enrolled dentists (473 dentists).
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595dentists
carry half of all adult caseload: 12.6% of the enrolled list.
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What this is not
4.8%
of enrolled LA dentists saw no Medi-Cal dental patients of any age in 2024, and 57.0% saw 100 or more adults. State law deactivates providers with no claims for a year, after attempts to contact them (W&I Code §14043.62); how consistently this is applied is not known. Most enrolled dentists do see Medi-Cal patients; the pattern is concentration.
Cumulative share of caseload, dentists ranked busiest first
LA County, CY2024 · 4,730 enrolled dentists · hover, or focus and use arrow keys
Known nationally. Measured here for LA.
Uneven participation in Medicaid dentistry is well documented. In their national 2017 sample of general and pediatric dentists, Nasseh, Fosse and Vujicic (2023) found that 67% had no Medicaid or CHIP child patients, while about 18% had more than 100. This project does not discover concentration. It adds four things: dentist-level numbers for LA County from public California files; the “49% would leave” figure restated in patient counts; a statewide analysis of who stopped seeing Medi-Cal patients between 2019 and 2024, which drives the central estimate; and a seven-year statewide trend.
Which dentists leave matters more than how many.
The California Dental Association has reported that 49% of the Medi-Cal dentists it surveyed said they would leave the program if the cuts take effect. In LA that would be 2,318 of 4,730 dentists. Depending on which ones, they held anywhere from 5.2% to 93.9% of the adult caseload of LA’s enrolled dentists.
34.2%
of the adult Medi-Cal caseload of LA’s enrolled dentists would lose its dentist if 49% of dentists left and exits followed the statewide 2019–2024 pattern.
Central estimate from the main version of the model: the median of 2,000 seeded simulations. Other reasonable versions give 29.0–37.7%, so read it as about a third. The simulation interval, 31.8–36.8%, covers chance only: not the choice of model, and not the assumption that future exits will look like past ones.
A scenario, not a forecast
The same 2,318 dentists leave. Four answers.
Share of LA adult caseload (CY2024) whose dentist is among the 49% who leave
How the central estimate works
- Measure who left. Take every California provider number (mostly dentists) with adult Medi-Cal patients in 2019 (9,877) and see which had no patients at all by 2024, tenth by tenth of 2019 volume. See the pattern.
- Give each LA dentist a weight. A dentist in LA’s quietest tenth gets the exit rate of the state’s quietest tenth, and so on up.
- Draw the 49%. Pick 2,318 LA dentists at random, weighted like a raffle where the tickets are those exit rates. Add up the adult caseload they held.
- Repeat. 2,000 times, re-sampling the 2019 history each time, with a fixed seed (2027) so anyone gets identical results.
- Vary the model. The raffle is one way to stretch five-year exit rates to exactly 49%, and it softens the gap between quiet and busy dentists: here the quietest tenth leaves 2.2 times as often as the busiest, against 3.2 times in history. The main version also ignores child volume. The checks below try the alternatives.
All the assumptions, in full
Who leaves in the central estimate
LA dentists grouped by 2024 adult caseload. Bars: average share of each group that leaves across the simulations.
The busiest groups hold most of the caseload and leave least often, which is why the estimate lands well below 49%.
Does the estimate hold up? Change one assumption at a time.
Median and 95% simulation interval (chance only) for each re-run. The bracket spans the medians of all 15 model versions. Same seed, same number of draws.
All 15 model versions
Median share of adult caseload that loses its dentist. Rows: how LA dentists are matched to the 2019–2024 history, by tenth of adult volume, by range of adult patient counts, or by adult and child volume together. Columns: how five-year exit rates are stretched to exactly 49%: the raffle; independent exits with scaled odds; rates scaled proportionally; or the history run for longer.
Try other scenarios
This explorer runs a simpler model in your browser: dentists leave with odds tilted toward quieter or busier dentists. It reproduces the two bounds exactly. It is not the history-based estimate above.
Of the dentists who leave, 50% come from the busiest half.
One draw, every dentist busiest → quietest. Bars: patients per dentist. leaves stays
Every answer at this exit rate
Share of caseload that loses its dentist, from “quietest leave first” to “busiest leave first”. Line: median of 40 browser draws per point; band: middle 90% of those draws (not the 95% interval used above). Click to jump to a scenario.
Before any cut, quieter dentists left far more often.
Statewide, 9,877 provider numbers (mostly dentists) had adult Medi-Cal patients in 2019. By 2024, 29.7% had no Medi-Cal dental patients at all. The quietest tenth left 3.2 times as often as the busiest. This is the pattern the central estimate borrows.
Share of 2019 provider numbers with no Medi-Cal patients of any age in 2024, by 2019 adult volume
California, all rendering provider numbers with adult patients in CY2019
“No patients in 2024” means the provider number is absent from the CY2024 file. That includes retiring, moving away, leaving Medi-Cal and switching provider numbers; the files cannot tell these apart. Dentists with only child patients in 2019 left at a rate of 47.6%.
Busy dentists left too.
Take every California provider number (mostly dentists) with 100 or more Medi-Cal patients in 2019 and look it up again in 2024. Each square is about 1% of that group. Here “none” means no adult patients (left) or no child patients (right); some of them may still see the other age group.
Adult patients
5,630 provider numbers (mostly dentists) with 100+ adult patient counts in 2019
Child patients
5,871 provider numbers (mostly dentists) with 100+ child patient counts in 2019
20.7%
of 2019’s high-volume adult provider numbers saw no adult Medi-Cal patients in 2024. For children: 20.5%.
- In 2024 they saw…AdultsChildren
Meanwhile, patient counts grew. Summed adult patient counts in the statewide file rose from 2,685,486 (2019) to 3,956,263 (2024), up 47.3%, partly from coverage and reporting changes (Health Plan of San Mateo rows appear only from CY2022). Provider numbers in the file went from 11,114 to 11,954.
Concentration is not new. For adults, it has eased.
The share of patient counts held by the busiest 10% of California provider numbers, every year from 2018 to 2024. For adults it fell from 48.1% to 42.7%. For children it rose from 56.0% to 59.9%. The adult decline holds on a stricter base and without the single largest provider number.
Share of patient counts held by the busiest 10%, California
Each year’s file, CY2018–CY2024 · hover or focus for values
The files carry no county or specialty, so this trend is statewide and may include some hygienists and clinic-level numbers. Health Plan of San Mateo rows appear from CY2022. 2020 was the first pandemic year.
What is scheduled, and when the data can show it.
Claims files appear about a year after each calendar year ends. The first year that includes the scheduled change, CY2027, is unlikely to appear before late 2028. A baseline is only useful if it exists first.
- 2025
- Published
CY2024 utilization file on the portal
Dental Utilization By Provider, CY2024: file dated Oct 22, 2025, portal record last updated Nov 2025. The newest claims year available.
CHHS Open Data Portal; dates in sources.json.
- Published
October 2025 enrolled-provider profile on the portal
Defines who counts as an enrolled LA dentist on this page.
CHHS Open Data Portal; dates in sources.json.
- 2026
- This project
Baseline numbers computed
All eight source files downloaded and fingerprinted; every number recomputed by one command. The source files are as downloaded on this date.
- Expected · estimate
CY2025 utilization file
Estimated from past files: the CY2023 and CY2024 portal records were last updated in January 2025 and November 2025. Planned update: when CY2025 appears, this page will be re-run with it and the changes noted here.
- 2027
- Budget calendar
Governor’s proposed 2027–28 budget
The first point at which the scheduled change can be confirmed, funded or delayed.
California Constitution, Art. IV, §12.
- Budget calendar
May Revision
The governor updates the budget proposal.
- Budget calendar
Legislature’s budget deadline
The last scheduled step before July 1.
California Constitution, Art. IV, §12.
- Scheduled · reported
Scheduled payment and coverage changes
About $1 billion in Proposition 56 supplemental dental payments are scheduled to end, and non-emergency dental benefits are scheduled to end for roughly 2.3 million immigrant adults. Either could be delayed again.
The $1 billion: CDA, June 29, 2026. The 2.3 million: Public Health Watch, Sept 15, 2026. The benefits delay is also reported by CalMatters/LAist, June 29, 2026. Not confirmed against DHCS documents; check DHCS before citing.
- Expected · estimate
CY2026 utilization file
The last full year before the scheduled change. Planned update: this page will be re-run with it, giving the final pre-change baseline.
- 2028
- Expected · estimate
CY2027 claims file
The first data that include months after the change. Re-running this analysis on it gives a before-and-after comparison against this baseline.
How it is built, and what it cannot say.
A desk analysis of public state files: no patients, dentists or staff were interviewed, and no private data was used. It is a baseline anyone can re-run and check, not a study of patient experience.
Enrolled dental providers
Profile of Enrolled Medi-Cal Dental FFS Providers and Safety Net Clinics, October 2025.Utilization by rendering provider
Dental Utilization By Provider, seven files, CY2018–CY2024.Count each cell once
Rows the state lists twice are counted once. Hidden counts (1–10) are set to 5.Match on provider number
Keep dentists listed in LA County; drop hygienists. One row per dentist, not per office.results.json
Every number on this page, with its definition. Charts read it in your browser.Counts are per dentist, not per office.
45.0% of LA dentists are listed under two or more practices, and the claims file has no office field. So this cannot say which neighborhoods depend on which dentists, only how concentrated the county is. For the same reason a dentist’s caseload includes any patients seen outside LA: dentists also listed in another county hold 47.7% of the adult and 59.6% of the child caseload.
The enrolled list is fee-for-service only.
The LA group comes from the state’s list of enrolled fee-for-service dental providers and safety net clinics, which leaves out dentists who work only in dental managed care. Statewide, 1,590 provider numbers with 2024 patients are missing from that list; they hold 10.2% of adult and 6.8% of child patient counts, mostly care given at safety net clinics.
A provider number is not always one dentist.
30 LA provider numbers have more than 5,000 child patients a year (11.3% of child caseload), more than one clinician could see; they are probably team or program billing. Without provider numbers above 5,000 patients (5 for adults, 30 for children), the busiest 10% hold 42.6% of adult and 60.9% of child caseload.
Patient counts, not patients.
A patient seen by two dentists appears in both counts. 1,508,927 is the summed adult patient counts of LA-listed dentists (including patients they saw elsewhere), not that many different adults.
Small counts are hidden.
The public files hide counts of 1–10; they are counted as 5 here. The table below re-runs the key numbers at 1 and at 10.
Two snapshots.
Enrollment is from October 2025; claims are from calendar 2024. How many dentists joined or left in between is unknown: the listing’s enrollment-date field cannot identify recent enrollees. Claims lag about a year.
Seen is not accepting.
Utilization shows who saw Medi-Cal patients, not who is taking new ones.
Statewide patterns stand in for LA.
The utilization files have no county, so the trend and the exit pattern are statewide. They may include some hygienists and clinic-level numbers.
A survey answer is not an exit.
The 49% is stated intent from a survey, used here as a scenario. Nothing on this page predicts how many dentists will actually leave.
Past exits had other causes.
The central estimate assumes cut-driven exits would follow the 2019–2024 pattern. Those exits came from retirement, moves, COVID-19 and business changes. A payment cut could hit busy practices differently.
Losing a dentist is not losing care.
A patient whose dentist leaves is counted as affected even if another dentist could absorb them. There is no model of capacity, travel or language.
Do the hidden counts change the story?
Key numbers re-run with every hidden cell counted as 1, 5 (used) or 10. The headline numbers barely move.
A correction, stated plainly
An early, unpublished version of the pipeline summed rows that the state files list two or three times (the same dentist and cell, with the name spelled differently). The finished pipeline counts each cell once. The fix moved 11 numbers, each by at most 4.6% of its value. The script still re-runs the old method next to the new one, and results.json keeps both sets, so anyone can confirm that the correction is the only difference.
Ground rules
The limits this project sets on itself.
- No dentist is named, mapped or ranked. The public files contain names; this project does not use them.
- No per-office numbers.
- Immigration status appears only in aggregate, statewide policy figures.
- No patient-level data, no scraping of private systems.
- Every number comes from results.json with its definition, produced by one script.
- Source data are credited to the CHHS Open Data Portal and labelled as modified data.
Check every number yourself.
Every figure on this page is in one file, next to its definition. The code is here too: one command rebuilds that file from the public downloads.
How to reproduce
Unzip the code and run these from its folder, with Node.js 18 or newer and no other packages. The script asks the CHHS Open Data API for each file, downloads the eight source files, checks their fingerprints and rebuilds data/results.json. Random draws use a fixed seed, so the results come out identical.
# rebuild every number from the public files
node analysis/run.cjs
# check the results (full recompute included)
node analysis/test.cjsAttribution
Source: California Health and Human Services Open Data Portal: “Dental Utilization By Provider” (CY2018–CY2024) and “Profile of Enrolled Medi-Cal Dental Fee-for-Service (FFS) Providers and Safety Net Clinics (SNCs)” (October 2025). Modified data: repeated rows were counted once, hidden cells were replaced by an assumed value, and files were joined and summarised by this project. These are not official figures of the State of California or DHCS.
CopiedSources
- CHHS Open Data Portal, Dental Utilization By Provider, CY2018–CY2024. Data from the California Department of Health Care Services.
- CHHS Open Data Portal, Profile of Enrolled Medi-Cal Dental FFS Providers and Safety Net Clinics, October 2025.
- Nasseh K, Fosse C, Vujicic M. Dentists Who Participate in Medicaid: Who They Are, Where They Locate, How They Practice. Medical Care Research and Review 2023;80(2). doi:10.1177/10775587221108751. Checked in the full text.
- California Welfare & Institutions Code §14043.62: providers with no Medi-Cal claims for one year are deactivated. Checked against the statute text.
- California Dental Association, poll published January 22, 2026: 1,527 responses, 990 from dentists enrolled in Medi-Cal; 49% said they would leave the program if the proposed rate cuts take effect. Self-reported intent; the article describes no sampling method. Checked in the CDA article.
- California Dental Association, “Medi-Cal Dental funding protected for another year in new state budget”, June 29, 2026: about $1 billion in proposed cuts to the Proposition 56 dental rates delayed to July 1, 2027. Read in the article; not confirmed against DHCS documents.
- Public Health Watch, “California Delayed Medi-Cal Dental Cuts for Immigrants, But Worry and Confusion Persist”, September 15, 2026: roughly 2.3 million immigrants set to lose non-emergency dental benefits on July 1, 2027. CalMatters, “Newsom’s parting gift: A budget that delays California’s deep cuts to 2027”, as published by LAist, June 29, 2026: the end of benefits for undocumented enrollees delayed to July 2027. News reporting; not confirmed against DHCS documents.