Dataset Information

Impact of Wisconsin Medicaid Policy Change on Dental Sealant Utilization.

ABSTRACT:

Background

In September 2006, Wisconsin Medicaid changed its policy to allow nondentists to become certified Medicaid providers and to bill for sealants in public health settings.

Objective

This study examined changes in patterns of dental sealant utilization in first molars of Wisconsin Medicaid enrollees associated with a policy change.

Data source

The Electronic Data Systems of Medicaid Evaluation and Decision Support for Wisconsin from 2001 to 2009.

Study design

Retrospective claims data analysis of Wisconsin Dental Medicaid for children aged 6-16 years.

Principal findings

A total of 479,847 children followed up for 1,441,300 person-years with 64,546 visits were analyzed. The rate of visits for sealants by dentists increased significantly from 3 percent per year prepolicy to 11 percent per year postpolicy, and that of nondentists increased from 18 percent per year to 20 percent after the policy change, but this was not significant. Non-Hispanic blacks had the lowest visit rates for sealant application by dentists and nondentists pre- and postpolicy periods.

Conclusions

The Wisconsin Medicaid policy change was associated with increased rates of visits for dental sealant placement by dentists. The rate of visits with sealant placements by nondentists increased at the same rate pre- and postpolicy change.

SUBMITTER: Okunseri C

PROVIDER: S-EPMC5785323 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Publications

Impact of Wisconsin Medicaid Policy Change on Dental Sealant Utilization.

Okunseri Christopher C Okunseri Elaye E Garcia Raul I RI Gonzalez Cesar C Visotcky Alexis A Szabo Aniko A

Health services research 20161212 1

<h4>Background</h4>In September 2006, Wisconsin Medicaid changed its policy to allow nondentists to become certified Medicaid providers and to bill for sealants in public health settings.<h4>Objective</h4>This study examined changes in patterns of dental sealant utilization in first molars of Wisconsin Medicaid enrollees associated with a policy change.<h4>Data source</h4>The Electronic Data Systems of Medicaid Evaluation and Decision Support for Wisconsin from 2001 to 2009.<h4>Study design</h4> ...[more]

PMID: 27957734

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Project description:ObjectiveThe goal of this study was to use claims data linked with community-level measures to evaluate the impact of preventive services on the time to subsequent restorative, advanced restorative, and complex dental treatment among children enrolled in the Virginia Medicaid program.MethodsFour data sources were used (dental claims, eligibility files, American Community Survey, and Area Health Resource Files) for fiscal years 2011 to 2018. The outcomes of interest were time to first treatment services from birth. The treatment outcomes were basic restorative treatment, advanced restorative treatment, or complex treatment. The independent variable was a preventive service prior to a treatment service. Time-to-event curves were estimated and compared using a log-rank test. Propensity score-matched univariate and multivariate Cox proportional hazards frailty models with an inverse probability censoring weighting correction estimated hazard ratios (HRs) for treatment outcomes comparing use of preventive services while controlling for patient demographic, geospatial, and county-level socioeconomic status measures.ResultsThe analysis included 430,594 children (10,204,182 claims). A log-rank test showed significant differences (P < 0.001) between the times to treatment of those who had a preventive service and those who did not have a preventive service prior to a treatment service. Both Kaplan-Meier curves and the adjusted HR (1.88; 95% confidence interval [CI], 1.46-2.15) indicated that children without preventive services were more likely to have basic restorative treatment at an earlier age along with advanced restorative treatment (HR, 1.52; 95% CI, 1.28-1.80) and complex treatment (HR, 2.13; 95% CI, 1.68-2.61).ConclusionsIn a population of Medicaid-enrolled children, children who did not receive preventive services were significantly more likely to have treatment at an earlier age than those who did receive preventive services.Knowledge transfer statementThis study examines the impact of the utilization of preventive dental services since birth and the subsequent dental treatment for children enrolled in a dental Medicaid program. This study also examines the influence of preventive care on dental complexity of treatment for these children. Findings can inform federal and state policy planning of dental Medicaid programs as well as interventions to improve referral systems for the early use of preventive dental services and the establishment of a dental home.

Dataset Information

Impact of Wisconsin Medicaid Policy Change on Dental Sealant Utilization.

Background

Objective

Data source

Study design

Principal findings

Conclusions

Publications

Impact of Wisconsin Medicaid Policy Change on Dental Sealant Utilization.

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