Does the Elimination of Medicaid Reimbursement Affect the Frequency of Emergency Department Dental Visits?

The Individual and Program Impacts of Eliminating Medicaid Dental Benefits in the Oregon Health Plan

“…25 The administrative data demonstrated that the OHP Standard population increased use of emergency department services for dental problems after losing dental coverage, similar to what the Maryland Medicaid study found. 26 We also found increases in use of non---emergency department ambulatory medical settings for dental problems, unlike another Maryland Medicaid study in which physician office visits for dental problems decreased after loss of dental coverage. 27 This difference in findings may reflect a broader definition of nonemergency ambulatory care in our study (e.g., hospital outpatient visits) or the availability of a comparison group to assess relative change over time.…”

“…25(p3) Another study, conducted in Maryland, found that the elimination of reimbursements to dentists for dental-related emergencies resulted in a 12% increase in dentalrelated emergency department visits. 26 That study also found an 8% decrease in dentalrelated primary care visits during the same time period. 27 In early 2003, changes made to Oregon's Medicaid Program resulted in the elimination of specific benefits, including dental coverage, and the imposition of copayments on the remaining covered care for one segment of the adult Medicaid population.…”

“…We identified services for dental problems in ambulatory medical settings by primary diagnosis consistent with previous research. 26,27 The specific Copayments for medical services were implemented (for Standard enrollees) at the same time that dental benefits were cut. To avoid potential confounding related to changes in medical service use caused by this separate policy change and not to the loss of dental benefits, we measured utilization of medical settings for dental problems as a percentage of any use within a specific general medical setting.…”

Emergency Department Visits for Nontraumatic Dental Problems: A Mixed-Methods Study

“…We defined an ED visit for a nontraumatic dental problem (ED dental visit) by a primary hospital discharge diagnosis with the following International Classification of Diseases, Ninth Revision codes 2,5,7,12,14,15,[19][20][21] : 520.0---520.9, 521.0---521.9, 522.0---522.9, 523.0---523.9, and 525.0---525. 9.…”

Effects of Cuts in Medicaid on Dental-Related Visits and Costs at a Safety-Net Hospital

“…Almost one third, 31.4%, of the 2010 ED visits were by people dependent on Medicaid or State Children's Health Insurance Program, 2 17.7% were by people with Medicare, and 16.6% were uninsured. 2 Cohen et al 3 examined ED use for the treatment of dental problems at the University of Maryland Medical System in 1995. They analyzed dental-related ED use before and after a change in coverage status for poor adults took place (in an attempt to reduce costs, in February 1993, the state of Maryland eliminated Medicaid reimbursement for dental care).…”