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APHA Scientific Session and Event Listing

Recorded presentation

Tracy Finlayson, PhD, School of Public Health, UC Berkeley, 140 Warren Hall, MC7360, Berkeley, CA 94720-7360, 510-642-5652, tracyf@berkeley.edu and Stephen Eklund, DDS, MHSA, DrPH, School of Public Health, University of Michigan, 611 Church Street, Rm. 352, Ann Arbor, MI 48109-3028.

Background: “Healthy Kids Dental” (HKD) is one component of the Michigan demonstration program to improve Medicaid children's access to dental services. HKD is administered through the Delta Dental Plan of Michigan in 37 select counties and reimburses providers at customary rates.

Objective: To evaluate trends in children's access to care, treatment patterns, dentist participation, and cost in the first four years of HKD.

Methods: Delta insurance claim and eligibility data from 2000-2004 for children in the 37 HKD counties were analyzed. The proportion of children by age enrolled and utilizing dental services in each 12-month period reflected trends in access to care. The number of participating dentists, average travel distance to provider, presence of a dental home, and differences in utilization patterns by length of enrollment were also investigated.

Results: More children have enrolled and utilized services each year under HKD. Children had a high probability of a dental visit if enrolled. More local dentists participated, and appeared to integrate HKD children into their practices and provided comprehensive treatment. Children received needed services from local providers close to home (average travel distance about 15 miles). At least 40% of HKD children likely had a dental home and more children appeared to be entering regular recall patterns. Costs increased each year, attributable to more children receiving care and a customary rate of reimbursement for services.

Conclusion: Access to care was significantly improved in HKD counties. This program can serve as a template for other states reforming their Medicaid program's dental component.

Learning Objectives:

• Articulate the components of an innovative policy to increase Medicaid children’s access to dental care.
• Describe children’s trends in enrollment, utilization, and access to care over the first few years of the new program.
• Discuss the policy implications of the program.

Keywords: Access to Care, Medicaid

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation