Abstract
Background: Oral health care use remains low among adult Medicaid recipients, despite the Patient Protection and Affordable Care Act's expansion increasing access to care in many states. It remains unclear the extent to which low use reflects either low demand for care or barriers to accessing care. The authors aimed to examine factors associated with low oral health care use among adults enrolled in Medicaid. Methods: The authors conducted a survey from May through September 2018 among able-bodied (n = 9,363) Medicaid recipients who were aged 19 through 65 years and nondisabled childless adults in Kentucky. The survey included questions on perceived oral health care use. Semistructured interviews were also conducted from May through November 2018 among a subset of participants (n = 127). Results: More than one-third (37.8%) of respondents reported fair or poor oral health, compared with 26.2% who reported fair or poor physical health. Although 47.6% of respondents indicated needing oral health care in the past 6 months, only one-half of this group reported receiving all of the care they needed. Self-reported barriers included lack of coverage for needed services and lack of access to care (for example, low provider availability and transportation difficulties). Conclusions: Low rates of oral health care use can be attributed to a subset of the study population having low demand and another subset facing barriers to accessing care. Although Medicaid-covered services might be adequate for beneficiaries with good oral health, those with advanced dental diseases and a history of irregular care might benefit from coverage for more extensive restorative services. Practical Implications: These results can inform dentists and policy makers about how to design effective interventions and policies to improve oral health care use and oral health outcomes.
Original language | English |
---|---|
Pages (from-to) | 747-755 |
Number of pages | 9 |
Journal | Journal of the American Dental Association |
Volume | 152 |
Issue number | 9 |
DOIs | |
Publication status | Published - Sept 2021 |
Bibliographical note
Publisher Copyright:© 2021 American Dental Association
Funding
Disclosures. Dr. Venkataramani reported receiving grants from the National Institutes of Health , the Robert Wood Johnson Foundation , and the Donoghue and Rx Foundation outside the submitted work. Dr. Volpp reported being part owner of the consulting firm VAL Health; receiving grants from Vitality/Discovery, the Hawaii Medical Services Association, and Oscar Insurance; and receiving grants and personal fees from CVS Health outside the submitted work. Dr. Underhill reported grants from the Donoghue and Rx Foundations outside the submitted work. Mr. Wang, Dr. Dixon, Ms. Bair, Mr. Ferrell, and Dr. Linn did not report any disclosures. This study was funded by a contract with the Commonwealth of Kentucky (principal investigators: Drs. Venkataramani, Volpp, and Underhill; co-investigator: Dr. Linn; project staff: Ms. Bair, Dr. Dixon, and Mr. Ferrell), funded by the Commonwealth of Kentucky and Centers for Medicare & Medicaid Services for the purposes of conducting a Centers for Medicare & Medicaid Services–required independent evaluation of the Commonwealth’s Medicaid demonstration waiver. The data analyzed during the evaluation are not publicly available as they are part of an ongoing evaluation, but a deidentified version of the quantitative data set is available from the corresponding author on reasonable request, pending agreement from the funders.
Funders | Funder number |
---|---|
Commonwealth of Kentucky | |
Oscar Insurance | |
National Institutes of Health | |
Robert Wood Johnson Foundation | |
Centers for Medicare and Medicaid Services | |
Hawaii Medical Service Association |
ASJC Scopus Subject Areas
- General Dentistry