Medicaid participation by private dentists in Alabama

Journal of Public Health Dentistry, 1986

A statewide mail survey of a stratified sample of 640 Michigan general dentists was conducted in 1983, with a response rate of 41 percent, n = 261. An analysis was performed to compare Medicaid and non-Medicaid providers. About half of all respondents reported that they were not seeing any Medicaid patients (Group 1); 29 percent reported that less than 10 percent of their patients were Medicaid-eligible (Group 2), and 22 percent reported that 10 percent or more of their patients were Medicaid-eligible (Group 3). Significant differences existed among the three groups for age of respondent, length of time in practice, and number of new patients seen each month. Respondents with greater percentages of Medicaid patients in their practices were more likely to be in group practice. Stratification of respondents by location suggested that rural providers were more likely than urban respondents to have some Medicaid patients in theirpractices. Over 40 percent of respondents from all groups reported themselves as being not busy enough. In 1984, more than one million persons in Michigan were eligible for Medicaid dental benefits, but only one-fourth of these individuals were recipients of dental care. Factors that may limit dentists' participation in the Medicaid program, despite the presence of a large eligible population and self-reported lack of busyness, are discussed.

Background. Finding dentists who treat Medicaid-enrolled children is a struggle for many parents. The purpose of this study was to identify non-reimbursement factors that influence the decision by dentists about whether or not to participate in the Medicaid program in Florida. Methods. Data from a mailed survey was analyzed using a logistic regression model to test the association of Medicaid participation with the Perceived Barriers and Social Responsibility variables. Results. General and pediatric dentists (n=882) who identified themselves as either Medicaid (14%) or Non-Medicaid (86%) participants responded. Five items emerged as significant predictors of Medicaid participation, with a final concordance index of 0.905. Two previously unreported barriers to participation in Medicaid emerged: 1) dentists' perception of social stigma from other dentists for participating in Medicaid, and 2) the lack of specialists to whom Medicaid patients can be referred. Conclusions. This study provides new information about non-reimbursement barriers to Medicaid participation.

2001

Purpose: This study was performed to determine factors asso- ciated with Louisiana dentists' participation in the Dental Medicaid Program. Methods: Surveys were mailed to all pediatric and general den- tists as reported by the Louisiana State Board of Licensing. A second mailing was made to non-respondents. Results: Surveys from 956 of 1,926 dentists (50%) were re- turned. Of 607 general dentists and 40 pediatric dentists who treated dental Medicaid-enrolled children in the past year, 269 (44%) and 18 (45%), respectively, treated all Medicaid-enrolled children. Newly graduated dentists were more likely to be actively enrolled than their more established counterparts (χ 2 =10.67; p=0.01). Medicaid reimbursement levels were viewed as "much less" than private fees by 62%, "less" by 33%, and "the same" by 4% of the respondents. Broken appointments were the most preva- lent reported problem (80%), followed by low fees (61%), patient non-compliance (59%)...

Journal of Public Health Dentistry, 2013

Objectives-The challenges entailed in dental Medicaid programs are well documented. To increase our understanding of Medicaid participation, we surveyed Florida dentists to determine the demographic and practice characteristics of Medicaid-participating dentists. Methods-Our target population was practicing Florida dentists who treat children, including those who do not currently accept Medicaid as well as those who do. The final sample (n = 882) included (1) pediatric dentists and (2) general dentists who self-reported that they treat children. Participants completed a survey concerning their Medicaid participation. Analyses included survey-sample weighted chi-square tests and multivariable logistic regression. Results-More than two-thirds of the sample dentists are not participating in Medicaid and will not consider doing so. Key findings are that Black dentists across the state and Hispanics in South Florida are more likely to participate in Medicaid than other groups of Florida dentists. Pediatric dentists are more likely to be Medicaid participants than general dentists, but nearly one-fifth of the pediatric dentists might quit participation. Non-Medicaid providers are more likely to report not being busy enough in their practice than Medicaid providers. Conclusions-If we are to address the shortage of Medicaid dental providers, increasing our understanding of how to capture the excess capacity among general dentists (the reported lack of busyness) in a way acceptable to dentists and to the State of Florida is an important first step. In addition, dental schools should consider implementing a track dedicated to training students for

Journal of Public Health Dentistry, 2013

The challenges entailed in dental Medicaid programs are well documented. To increase our understanding of Medicaid participation, we surveyed Florida dentists to determine the demographic and practice characteristics of Medicaid-participating dentists. Methods: Our target population was practicing Florida dentists who treat children, including those who do not currently accept Medicaid as well as those who do. The final sample (n = 882) included (1) pediatric dentists and (2) general dentists who self-reported that they treat children. Participants completed a survey concerning their Medicaid participation. Analyses included survey-sample weighted chi-square tests and multivariable logistic regression. Results: More than two-thirds of the sample dentists are not participating in Medicaid and will not consider doing so. Key findings are that Black dentists across the state and Hispanics in South Florida are more likely to participate in Medicaid than other groups of Florida dentists. Pediatric dentists are more likely to be Medicaid participants than general dentists, but nearly one-fifth of the pediatric dentists might quit participation. Non-Medicaid providers are more likely to report not being busy enough in their practice than Medicaid providers. Conclusions: If we are to address the shortage of Medicaid dental providers, increasing our understanding of how to capture the excess capacity among general dentists (the reported lack of busyness) in a way acceptable to dentists and to the State of Florida is an important first step. In addition, dental schools should consider implementing a track dedicated to training students for practice success within communities of highest dental need and to seek to increase the number of Black dental students.

Journal of Public Health Dentistry, 2008

Objectives: Medicaid enrollees disproportionately experience dental disease and difficulties accessing needed dental care. However, little has been documented on the factors associated with the acceptance of new Medicaid patients by dentists, and particularly whether minority dentists are more likely to accept new Medicaid patients. We therefore examined the factors associated with the acceptance of new Medicaid patients by dentists. Methods: We analyzed 2001 data from the Wisconsin Dentist Workforce Survey administered by the Wisconsin Division of Health Care Financing, Bureau of Health Information. We used descriptive statistics and logistic regression analysis to examine the factors associated with the outcome variable. Results: Ninety-four percent of Wisconsin licensed dentists (n = 4,301) responded to the 2001 survey. A significantly higher likelihood of accepting new Medicaid patients was found for racial/ethnic minority dentists (35 versus 19 percent of White dentists) and dentists practicing in large practices (31 versus 16 percent for those in smaller practices). In the multivariable analysis, minority dentists [odds ratio (OR) = 2.06, 95 percent confidence interval (CI) = 1.30, 3.25] and dentists in practices with >3 dentists (OR = 2.25, 95 percent CI = 1.69, 3.00) had significantly greater odds of accepting new Medicaid patients. Conclusions: Racial/ethnic minority dentists are twice as likely as White dentists to accept new Medicaid patients. Dentists in larger practices also are significantly more likely than those in smaller practices to accept new Medicaid patients. These findings suggest that increasing dental workforce diversity to match the diversity of the general US population can potentially improve access to dental care for poor and minority Americans, and may serve as an important force in reducing disparities in dental care.

2013

JAMA Network Open

IMPORTANCE Evaluating the availability of dentists to provide dental care services to children is important for identifying interventions for improving access. OBJECTIVE To assess dental care availability for children in the US by public insurance participation, rural-urban setting, and dentist taxonomy (general, pediatric, or specialized). DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study analyzed the availability of dentists from matching 3 data sets: the 2020 National Plan and Provider Enumeration System, the 2019-2020 State Board of Dentistry information acquired from each state, and the 2019 InsureKidsNow.org database. Data on active dentists in most states (including the District of Columbia [combined hereinafter with states] and excluding Hawaii and Washington) were included in the analysis. The study was conducted from January 2019 to March 2022. MAIN OUTCOMES AND MEASURES The number and percentage of dentists participating in public insurance programs (Medicaid and/or Children's Health Insurance Program [CHIP]) were aggregated at the dental office and stratified by the rurality of their practice and taxonomy. State-level comparisons were derived between this study and reports from the Health Policy Institute of the American Dental Association, along with maps and summary statistics disseminated through a data portal and state reports. RESULTS Among 204 279 active dentists, participation in public insurance varied widely across states, especially for the states that manage the Medicaid and CHIP programs separately. Participation rates in Medicaid and CHIP varied substantially from those of the Health Policy Institute of the American Dental Association. Participation in Medicaid and CHIP was lowest among urban dentists (Medicaid, 26%; CHIP, 29%) and highest among rural dentists (Medicaid, 39%; CHIP, 40%), while urban dentists accounted for most of the dentist population (urban, 84%; rural, 5%). Similarly, participation in Medicaid and CHIP was substantially lower among general dentists (Medicaid, 28%; CHIP, 29%) vs pediatric dentists (57% in both programs), while each state's dentist population consisted of notably more general (84%) than pediatric (3%) dentists. Nearly half of the states revealed wide variations in Medicaid and CHIP participation between counties, ranging from no participation (21 states) to full participation (22 states). CONCLUSIONS AND RELEVANCE The findings of this study suggest that disparities in the availability of dentists for pediatric dental care are extensive, particularly for Medicaid-and CHIPinsured children, those living in rural communities, and those receiving specialized care. Lack of dentist availability for Medicaid-and CHIP-insured children appears to deter access to receiving dental care.

This study was supported by the Missouri Department of Health. The results and views expressed are the independent products of university research and do not necessarily represent the view of the funding agencies. i Preface The purpose of this project is to assist the Missouri Department of Social Services in providing improved access to dental care for Medicaid recipients, to evaluate aspects of the Medicaid dental program in Missouri, and to develop a series of policy options for improving the program. Missouri dentists were sent a questionnaire regarding utilization of dental services by Medicaid enrolled children, attitudes and participation of Missouri dentists in the Medicaid program, and factors affecting dentist participation in the program. From this data, policy options for improving the Medicaid dental program will be recommended.

Health Services Research, 2005