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The Effect of Medicaid Primary Care Provider Reimbursement on Access to Early Childhood Caries Preventive Services

Authors

  • Jill Boylston Herndon Ph.D.,

    Corresponding author
    1. Department of Health Outcomes and Policy, College of Medicine, Institute for Child Health Policy, University of Florida, Gainesville, FL
    • Address correspondence to Jill Boylston Herndon, Ph.D., Department of Health Outcomes and Policy, College of Medicine, Institute for Child Health Policy, University of Florida, PO Box 100177, Gainesville, FL 32610-0177; e-mail: herndojb@ufl.edu.

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  • Scott L. Tomar D.M.D., M.P.H., Dr.P.H.,

    1. Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL
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  • Frank A. Catalanotto D.M.D.,

    1. Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL
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  • W. Bruce Vogel Ph.D.,

    1. Department of Health Outcomes and Policy, College of Medicine, Institute for Child Health Policy, University of Florida, Gainesville, FL
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  • Elizabeth A. Shenkman Ph.D.

    1. Department of Health Outcomes and Policy, College of Medicine, Institute for Child Health Policy, University of Florida, Gainesville, FL
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Abstract

Objective

To examine receipt of early childhood caries preventive services (ECCPS) in two states' Medicaid programs before and after the implementation of reimbursement to medical primary care providers (M-PCPs).

Data Sources

Enrollment and claims data from the Florida and Texas Medicaid programs for children ≤54 months of age during the period 2006–2010.

Study Design

We conducted time trend-adjusted, difference-in-differences analyses by using modified Poisson regressions combined with generalized estimating equations (GEEs) to analyze the effect of M-PCP reimbursement on the likelihood that an enrollee had an ECCPS visit after controlling for age, sex, health status, race/ethnicity, geographic location, and enrollment duration.

Data Extraction Methods

Enrollment data were linked to claims data to create a panel dataset with child-month observations.

Principal Findings

Reimbursement to M-PCPs was associated with an increased likelihood of ECCPS receipt in general and topical fluoride application specifically in both states.

Conclusions

Reimbursement to M-PCPs can increase access to ECCPS. However, ECCPS receipt continues to fall short of recommended care, presenting opportunities for performance improvement.

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