Increased Use of Dental Services by Children Covered by Medicaid: 2000–2010

Abstract

This report analyzes the use of dental services by children enrolled in Medicaid from federal fiscal years (FFY) 2000 to 2010. The number and percent of children receiving dental services under Medicaid climbed continuously over the decade. In FFY 2000, 6.3 million children ages 1 to 20 were reported to receive some form of dental care (either preventive or treatment); the number more than doubled to 15.4 million by FFY 2010. Part of the increase was because the overall number of children covered by Medicaid rose by 12 million (50%), but the percentage of children who received dental care climbed appreciably from 29.3% in FFY 2000 to 46.4% in FFY 2010 In that same time period, the number of children ages 1 to 20 receiving preventive dental services climbed from a reported 5.0 million to 13.6 million, while the percentage of children receiving preventive dental services rose from 23.2% to 40.8%. For children ages 1 to 20 who received dental treatment services, the reported number rose from 3.3 million in FFY 2000 to 7.6 million in FFY 2010. The percentage of children who obtained dental treatment services increased from 15.3% to 22.9%. In FFY 2010, about one sixth of children covered by Medicaid (15.7%) ages 6-14 had a dental sealant placed on a permanent molar. While most states have made steady progress in improving children's access to dental care in Medicaid over the past decade, there is still substantial variation across states and more remains to be done. Ku, L., Sharac, J., Bruen, B., Thomas, M., Norris, L. Keywords: E2 BackgroundIn 2007, the tragic death of a 12-year-old Maryland boy, Deamonte Driver, who died from a brain infection caused by an untreated tooth infection, brought attention to the difficulties Medicaid-enrolled children could face in accessing dental care (Otto, 2007). It also prompted lawmakers to include in the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) a requirement for CHIP programs to cover dental services starting in 2010, a requirement for the Department of Health and Human Services to provide clients with a Web site listing dentists who serve Medicaid or CHIP clients, and an order for the Government Accountability Office to conduct an analysis of the receipt of, and barriers to, dental services provided to Medicaid-enrolled children (GAO, 2010). The report found that in federal fiscal year (FFY) 2008, only 36% had received any dental service, 32% had received a preventive dental service, and 18% had received a dental treatment service. In eight states, 30% or less of Medicaid-enrolled children had received any dental service. While these percentages represented progress in that they were higher than the percentages for fiscal year 2001, they still reflected Medicaid's failure to adequately ensure children's access to dental services.Dental care is a key component of Medicaid's Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit. EPSDT does not apply to adult Medicaid beneficiaries, so dental care is an optional service for ...

Access to Dental Care and the Oral Health Safety Net

“…53 This utilization rate for Medicaid-enrolled children has been increasing since 2000, when only 27.1% of Medicaid-enrolled children received a dental visit nationwide. 53,76 Despite these increases, there have continued to be disparities in utilization of dental services between privately insured and non-privately insured children during this period (Figure 11). 77 Figure 11.…”

Care delivery and compensation system changes: a case study of organizational readiness within a large dental care practice organization in the United States

“…Government payments for dental services are moving from traditional fee-for-service to capitated or per member fixed payments with greater accountability for increasing the proportion of enrollees who receive care. Although low-income children enrolled in government insurance in the United States are entitled to dental care by law, utilization is low: in 2010, less than half of children had any dental care (46%) or preventive care (42%) [ 5 ].…”

Effect of Family Income on the Relationship Between Parental Education and Sealant Prevalence, National Health and Nutrition Examination Survey, 2005–2010

“…Increasing sealant prevalence among children at risk for caries is a national health objective (7). Both the Centers for Medicare and Medicaid Services (8) and the National Quality Forum (9) have endorsed performance measures related to increased sealant prevalence among Medicaid-enrolled and privately insured children, respectively, who are at risk for caries.…”