Address correspondence to Inyang Isong, M.D., M.P.H., S.M., Instructor in Pediatrics, Harvard Medical School, Center for Child and Adolescent Health Policy, Massachusetts General Hospital for Children, 50 Staniford Street, Suite 901, Boston, MA 02114; e-mail: firstname.lastname@example.org. Hugh Silk, M.D., M.P.H., Clinical Associate Professor, is with the Hahnemann Family Health Center, University of Massachusetts Medical School and Family Medicine Residency, Worcester, MA. Sowmya R. Rao, Ph.D., Associate Professor, is with the Center for Health Quality, Outcomes & Economics Research, University of Massachusetts Medical School, Veterans Administration, Worcester, MA. James M. Perrin, M.D., Professor of Pediatrics and Karen Donelan, Sc.D., Instructor in Medicine, are with the Harvard Medical School, Center for Child and Adolescent Health Policy, Massachusetts General Hospital for Children, Boston, MA. Judith Savageau, M.P.H., Associate Professor, is with the Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA. Karen Donelan, Sc.D., Senior Scientist, is with the Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA.
Provision of Fluoride Varnish to Medicaid-Enrolled Children by Physicians: The Massachusetts Experience
Article first published online: 15 JUL 2011
© Health Research and Educational Trust
Health Services Research
Volume 46, Issue 6pt1, pages 1843–1862, December 2011
How to Cite
Isong, I. A., Silk, H., Rao, S. R., Perrin, J. M., Savageau, J. A. and Donelan, K. (2011), Provision of Fluoride Varnish to Medicaid-Enrolled Children by Physicians: The Massachusetts Experience. Health Services Research, 46: 1843–1862. doi: 10.1111/j.1475-6773.2011.01289.x
- Issue published online: 16 NOV 2011
- Article first published online: 15 JUL 2011
- preventive dental care;
- fluoride varnish;
Objectives. To evaluate the impact of a 2008 Medicaid policy in Massachusetts (MA), regarding reimbursing physicians for providing fluoride varnish (FV) to eligible children in medical settings.
Data Source. Survey of a sample of primary care physicians in MA.
Study Design. Cross-sectional survey of a sample of physicians who provide care to MassHealth (MA Medicaid) enrolled-children. Dependent variables: history of completed preventive dental skills training, and FV provision. Independent variables: oral health knowledge, FV-attitudes, and physician and practice characteristics.
Principal Findings. Overall, 19 percent of respondents had completed the training required to be eligible to bill for FV provision. Only 5 percent of physicians were providing FV. Most respondents (63 percent) were not familiar with the new policy, and only 25 percent felt that FV should be provided during well-child visits. Most physicians (60 percent) did not feel that the reimbursement rate of U.S.$26/application was sufficient; 17 percent said that they would not provide FV, regardless of payment. Most common barriers to FV provision were a lack of time and logistical challenges.
Conclusions. Our findings suggest that simply reimbursing physicians for FV provision is insufficient to ensure provider participation. Success of this policy will likely require addressing several barriers identified.