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More Medicaid and privately insured children going to the dentist

Gap remains high for adults

October 05, 2015 A research brief from the Association's Health Policy Institute finds that while the gap has narrowed for Medicaid and privately insured children utilizing dental care, a very large gap remains for adults.

The "Gap in Dental Care Utilization Between Medicaid and Privately Insured Children Narrows, Remains Large for Adults," released Aug. 28, found that between 2005 and 2013, dental care utilization among Medicaid-enrolled children increased in all but one state: to 48.3 percent, up from 35.3 percent, nationally. This resulted in a significant narrowing of the gap in dental care utilization between Medicaid-enrolled children and children with private dental benefits.

Dental care utilization for children with private dental benefits also increased nationally: to 64 percent in 2013, up from 59.8 percent in 2005.

However, while more children are visiting the dentist, the majority of states saw declines in dental care use among adults with private dental benefits, with the overall total decreasing to 59.2 percent in 2013, down from 60.2 percent in 2005. The report analyzed the gap between Medicaid-enrolled adults and adults with private dental benefits in 21 states.

Authors Marko Vujicic, Ph.D., HPI chief economist and vice president, and Kamyar Nasseh, Ph.D., HPI economist, attributed the gain in dental care utilization among Medicaid children to several states implementing "comprehensive, multipronged reforms" to their dental programs as well as the lower overall cost of treating children. To help narrow the gap for adults, they urged policymakers to focus on reforms to Medicaid.

These are not "new" trends, they noted. "Federal and state policymakers simply have not prioritized adult dental to the same level as for children."

In calculating the dental care utilization rates for children, the authors gathered 2005 and 2013 data from the Centers for Medicare and Medicaid Services 416 form. For adults, they received dental care utilization data from the Medicaid Statistical Information System database and all data were collected and analyzed by CMS and Mathematica Policy Research. For adults and children with private dental benefits they used integrated medical, pharmacy and dental claims from Truven Health Analytics MarketScan Research Databases.

Read the full research brief here. There is also a webinar recording. More information is available from the ADA Health Policy Institute at hpi@ada.org.