Increasing Access to Dental Care in Medicaid: Does Raising Provider Rates Work?

National Academy for State Health Policy

This issue brief examines the results of Medicaid dental reforms in six states to gauge the impact of provider rate increases against other program improvements, such as streamlined administrative procedures and outreach to dental societies.

March 2008

Dentist participation in Medicaid has been a persistent problem, with less than one in four dentists nationwide seeing more than a handful of Medicaid patients in any given year. The most common reason dentists give for their low participation is inadequate reimbursement for the cost of treating Medicaid beneficiaries.

Beginning in the late 1990s, several states greatly increased Medicaid rates for dentists, while also overhauling administrative processes and working to forge stronger ties with dental practitioners and other stakeholders in the field. This issue brief examines the results of those reforms and whether the efforts at better administration and outreach mattered as much as the rate increases in improving access to Medicaid dental care. Those findings are also compared with information on provider rates and participation in California.

The research indicates that while increases in provider payments were necessary to the success of the states' reform efforts, they were not sufficient to produce substantial gains in either dentist participation or patients' access to care. The authors conclude that in addition to raising reimbursement rates, Medicaid agencies must also revamp their administrative procedures and build partnerships with dental societies.

The complete issue brief is available under Document Downloads. Also available are the slides from a March 20, 2008, presentation by study authors Shelly Gehshan and Andrew Snyder in Sacramento at the California HealthCare Foundation's State Health Policy Office.

A report detailing the research on which the brief is based can be found on the National Academy for State Health Policy site through the External Link below.