Dental Care for People Living with HIV/AIDS in Massachusetts

Objectives: In July 2010, the Massachusetts Medicaid Program  severely reduced their adult dental program. This presentation will review the impact of these cuts on a payer of last resort federal program with a fixed budget.

Methods: Data were collected for 628 low-income adults living with HIV/AIDS who were enrolled in the HIV DOP and MassHealth (2010-2012). We analyzed  type of dental services, frequency of dental visits, expenditures on dental services, and the source of payment for dental care.

Results: The results were that between July 2010 and June 2012, 3481 dental procedures were rendered to the clients of the HIV DOP. Restorative, periodontics and prosthodontics procedures represented more than 80 % of all dental procedures provided. The total expenditures for dental service were $536,127, financed mainly (90%) through the Ryan White HIV/AIDS Program. The principal expenditures were for restorative dental services which accounted for 42 percent of total dental expenditures followed by 36% of total dental expenditures for prosthodontics, while the expenditures for diagnostic and preventive services represent only 2 percent of total dental expenditures.

Conclusion: The findings indicate that the HIV Dental Ombudspersons Program provided Safety Net Dental Care for this vulnerable population. However, the majority of services they had to cover due to the cuts were costly non-preventive dental services which were eliminated in MassHealth after July 2010. These findings demonstrated the impact on a resource limited federally funded program when other payer sources change and could assist other programs facing a similar dilemna.