Comparison of Dental and Medical Medicaid in New York with the nation

OBJECTIVE: To understand the disparities in Dental and Medical Medicaid program in New York compared to the nation in terms of the access to care, available services, enrollees and expenditures. METHOD OF STUDY: Data was collected from the New York State Department of Health and Kaiser Family Foundation. It included the expenditures, claims and recipients of all Medicaid medical and dental services for three consecutive fiscal years (2001, 2002 and 2003) for New York City, State and country in three age groups of 0-20 years; 21 to 64 years and 65 plus. FINDINGS: Significant amount of disparities in Medical and Dental Medicaid expenditures, services rendered and enrollees in New York and the rest of the country. Highest expenses in New York with lowest percentage of eligible enrolled in the program. Simplifying enrollment process in fiscal year 2002 significantly increased the number of enrollees and increased dental reimbursement rates in 2003, increased dentist participation. Increase in the number of enrollees during fiscal year 2002, did not increase the overall health expenditure in the state. Only one fifth of adult Medicaid recipients utilized dental Medicaid services. Dental expenditure never exceeded two percent of total Medicaid expenditure. Reasons for disparity include misalignment of funds, low dental reimbursement rates, lowest dentist's participation in New York especially in SCHIP program compared to the country, and costs of managed care plans. CONCLUSION: Immediate implementation of reformed policies to reduce Medicaid inefficiencies, simplify enrollment process, increase dental reimbursements and better alignment of Medicaid expenditures in New York.