Get access

Increased Children's Access to Fluoride Varnish Treatment by Involving Medical Care Providers: Effect of a Medicaid Policy Change

Authors

  • Christopher Okunseri,

    1. Department of Clinical Services, Room 356, Marquette University School of Dentistry, P.O. Box 1881, Milwaukee, WI 53201-1881,
    Search for more papers by this author
    • Address correspondence to Christopher Okunseri, B.D.S., M.Sc., D.D.P.H.R.C.S.E., F.F.D.R.C.S.I., Department of Clinical Services, Room 356, Marquette University School of Dentistry, P.O. Box 1881, Milwaukee, WI 53201-1881; e-mail: christopher.okunseri@marquette.edu. Aniko Szabo, Ph.D., and Scott Jackson, M.S., are with the Division of Biostatistics, Department of Population Health, Medical College of Wisconsin, Milwaukee, WI. Nicholas M. Pajewski, Ph.D., Section on Statistical Genetics, University of Alabama at Birmingham, Birmingham, AL. Raul I. Garcia, D.M.D., M.M.Sc., Department of Health Policy and Health Services Research, Boston University School of Dental Medicine, Boston, MA.

  • Aniko Szabo,

    1. Division of Biostatistics, Department of Population Health, Medical College of Wisconsin, Milwaukee, WI,
    Search for more papers by this author
  • Scott Jackson,

    1. Division of Biostatistics, Department of Population Health, Medical College of Wisconsin, Milwaukee, WI,
    Search for more papers by this author
  • Nicholas M. Pajewski,

    1. University of Alabama at Birmingham, Birmingham, AL,
    Search for more papers by this author
  • Raul I. Garcia

    1. Department of Health Policy and Health Services Research, Boston University School of Dental Medicine, Boston, MA.
    Search for more papers by this author

Abstract

Background. In 2004, the State of Wisconsin introduced a change to their Medicaid Policy allowing medical care providers to be reimbursed for fluoride varnish treatment provided to Medicaid enrolled children.

Objective. To determine the extent by which a state-level policy change impacted access to fluoride varnish treatment (FVT) for Medicaid enrolled children.

Data Source. The Electronic Data Systems of Medicaid Evaluation and Decision Support database for Wisconsin from 2002 to 2006.

Study Design. We analyzed Wisconsin Medicaid claims for FVT for children between the ages of 1 and 6 years, comparing rates in the prepolicy period (2002–2003) to the period (2004–2006) following the policy change.

Principal Findings. Medicaid claims for FVT in 2002–2003 totaled 3,631. Following the policy change, claims for FVT increased to 28,303, with 38.0 percent submitted by medical care providers. FVT rates increased for children of both sexes and all ages, rising from 1.4 per 1,000 person-years of enrollment in 2002–2003 to 6.6 per 1,000 person-years in 2004–2006. Overall, 48.6 percent of the increase in FVT was attributable to medical care providers. The largest increase was seen in children 1–2 years of age, among whom medical care providers were responsible for 83.5 percent of the increase.

Conclusions. A state-level Medicaid policy change was followed by both a significant involvement of medical care providers and an overall increase in FVT. Children between the ages of 1 and 2 years appear to benefit the most from the involvement of medical care providers.

Ancillary