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

Abstract

Our findings have implications for state Medicaid policymakers by enabling access to data regarding dental providers' level of participation in Medicaid in addition to identifying factors predictive of such participation. This information will inform Medicaid program plans and provider recruitment efforts.

Delivery of Preventive Oral Health Services by Rurality: A Cross‐Sectional Analysis

“…All children had low rates of POHS in dental offices, consistent with prior studies, with children living in the most rural areas (ie, not adjacent to metro counties) having the lowest rate of POHS in dental offices. Medicaid‐enrolled children living in the most rural counties encounter barriers to dental care, including a limited dental workforce, which is exacerbated for this subpopulation because many general dentists are reluctant to treat young children or accept Medicaid . While substantial numbers of rural children received Medicaid‐reimbursed POHS in medical offices, given that less than half of rural children receive any POHS services annually, continuing to increase the integration of oral health care into primary care provides an ongoing opportunity to increase delivery of POHS to young children in rural counties .…”

“…Medicaid-enrolled children living in the most rural counties encounter barriers to dental care, including a limited dental workforce, 20 which is exacerbated for this subpopulation because many general dentists are reluctant to treat young children 21,22 or accept Medicaid. [29][30][31] While substantial numbers of rural children received Medicaid-reimbursed POHS in medical offices, given that less than half of rural children receive any POHS services annually, continuing to increase the integration of oral health care into primary care provides an ongoing opportunity to increase delivery of POHS to young children in rural counties. [36][37][38][39] Additional strategies to do so include using nontraditional settings to deliver POHS (eg, deliver care in Special Supplemental Nutrition Program for Women, Infants and Children [WIC] clinics), 40 providing Medicaid dental benefits to mothers until their children's fifth birthday, 37 and applying incentives and penalties for failing to meet utilization benchmarks to dental plans operating in states with Medicaid managed care.…”

“…With few pediatric dentists practicing in rural areas, children in rural areas often have to travel far for a dental visit . An additional challenge to obtaining dental care for children living in rural areas, who are more likely to live in poverty and have public insurance compared to children living in urban areas, is the reluctance of many dentists to accept Medicaid …”

“…[25][26][27] An additional challenge to obtaining dental care for children living in rural areas, who are more likely to live in poverty and have public insurance compared to children living in urban areas, 28 is the reluctance of many dentists to accept Medicaid. [29][30][31][32] Unsurprisingly, rates of annual preventive dental visits for children 1 to 5 years of age are lower in large rural areas (48.3%) compared with small rural areas (52.9%) and urban areas (55.3%). 4 There is a paucity of information regarding the impact of integrating POHS in medical offices in rural areas, despite the importance of understanding how such integration may increase receipt of POHS.…”

The association of dental education with pediatric Medicaid participation

“…For example, an analysis of Indiana Medicaid claims found that among "Medicaid-enrolled" dentists, 25% lacked any Medicaid claims in a year, while 27% had 800 or more. 29 Regrettably, our sources lack data on the actual volume of Medicaid claims.…”