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The effect of Medicaid primary care provider reimbursement on access to early childhood caries preventive services


The effect of Medicaid primary care provider reimbursement on access to early childhood caries preventive services



Health Services Research 50(1): 136-160



ISSN/ISBN: 0017-9124

PMID: 25039907

DOI: 10.1111/1475-6773.12200

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). Enrollment and claims data from the Florida and Texas Medicaid programs for children ≤54 months of age during the period 2006-2010. 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. Enrollment data were linked to claims data to create a panel dataset with child-month observations. Reimbursement to M-PCPs was associated with an increased likelihood of ECCPS receipt in general and topical fluoride application specifically in both states. 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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Accession: 056295814

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