The effect of Medicaid primary care provider reimbursement on access to early childhood caries preventive services

Health Serv Res. 2015 Feb;50(1):136-60. doi: 10.1111/1475-6773.12200. Epub 2014 Jul 9.

Abstract

Objective: To examine receipt of early childhood caries preventive services (ECCPS) in two states' Medicaid programs before and after the implementation of reimbursement to medical primary care providers (M-PCPs).

Data sources: Enrollment and claims data from the Florida and Texas Medicaid programs for children ≤54 months of age during the period 2006-2010.

Study design: We conducted time trend-adjusted, difference-in-differences analyses by using modified Poisson regressions combined with generalized estimating equations (GEEs) to analyze the effect of M-PCP reimbursement on the likelihood that an enrollee had an ECCPS visit after controlling for age, sex, health status, race/ethnicity, geographic location, and enrollment duration.

Data extraction methods: Enrollment data were linked to claims data to create a panel dataset with child-month observations.

Principal findings: Reimbursement to M-PCPs was associated with an increased likelihood of ECCPS receipt in general and topical fluoride application specifically in both states.

Conclusions: Reimbursement to M-PCPs can increase access to ECCPS. However, ECCPS receipt continues to fall short of recommended care, presenting opportunities for performance improvement.

Keywords: Medicaid; early childhood caries; preventive services; reimbursement.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Child, Preschool
  • Dental Care / economics
  • Dental Care / statistics & numerical data*
  • Dental Caries / prevention & control*
  • Female
  • Florida
  • Health Services Accessibility / economics
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Infant
  • Insurance, Health, Reimbursement*
  • Male
  • Medicaid / economics*
  • Poisson Distribution
  • Primary Health Care / economics
  • Primary Health Care / statistics & numerical data*
  • Texas
  • United States