Barriers to Medicaid Participation among Florida Dentists

Abstract

Background Finding dentists who treat Medicaid-enrolled children is a struggle for many parents. The purpose of this study was to identify non-reimbursement factors that influence the decision by dentists about whether or not to participate in the Medicaid program in Florida. Methods Data from a mailed survey was analyzed using a logistic regression model to test the association of Medicaid participation with the Perceived Barriers and Social Responsibility variables. Results General and pediatric dentists (n=882) who identified themselves as either Medicaid (14%) or Non-Medicaid (86%) participants responded. Five items emerged as significant predictors of Medicaid participation, with a final concordance index of 0.905. Two previously unreported barriers to participation in Medicaid emerged: 1) dentists’ perception of social stigma from other dentists for participating in Medicaid, and 2) the lack of specialists to whom Medicaid patients can be referred. Conclusions This study provides new information about non-reimbursement barriers to Medicaid participation.

Dental safety net capacity: An innovative use of existing data to measure dentists’ clinical engagement in state Medicaid programs

“…This study also assessed whether certain characteristics of Medicaid‐enrolled dentists were associated with their level of participation in state Medicaid programs. Findings revealed that significant predictors of the level of clinical engagement are consistent with previous literature examining factors influencing Medicaid enrollment . These consistencies provide some external validity to this new method of measuring levels of Medicaid participation.…”

“…Our findings validate several demographic and practice characteristics of dentists [i.e., job status, self‐reported Medicaid participation, age, race, dental practice type ] as predictors of their participation in state Medicaid programs. Just as importantly, our study provides a novel method of measuring the relative contribution (clinical engagement) of dentists in state Medicaid programs by examining Medicaid claims counts and DHPSA designation resources in addition to state‐based licensure data.…”

Dental Student, Resident, and Faculty Attitudes Toward Treating Medicaid Patients

“…The study used the Deamonte Driver scenario survey, which measures factors affecting dentists’ participation in Medicaid 1 , 10 . The instrument, developed by Logan et al, did not report a factor structure in their study 1 . Therefore, for our study, the three‐factor solution reported by Behar‐Horenstein and Garvan was used 10 .…”

“…Failure to receive proper oral health care, including both prevention and maintenance, is influenced by myriad and complex social, economic, and dental factors, including access to care. Access to care is often dictated by patients’ or their family's ability to pay for the care or to afford dental insurance and is limited by the low participation of dentists in Medicaid, a federal‐state insurance program for low‐income individuals 1 . These barriers may lead to low utilization of dental services as well as limited knowledge about the relationship between oral and systemic health.…”

Expected Changes in Regulation and Licensure: Influence on Future Education of Dentists

“…While social justice is not explicitly mentioned, there is mention of core professional attributes such as altruism and social responsibility, both key issues with respect to treating underserved and diverse patients. Recent research reports cast unfavorable light on dentists’ attitudes towards these issues 42 – 46 . CODA standards related to altruism and social responsibility need further reinforcement in dental education in order to make progress in improving access and practice in increasingly diverse settings.…”