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The Impact of Increased Dental Reimbursement Rates
             on Children Enrolled in Medicaid
    Helping Children Get Access to Dental Care - Key Findings and Recommendations
The Consequences of Not Going to the Dentist


Well-established research illustrates
the consequences of inadequate
access to basic dental care for
children:


• More oral disease,
• More dental pain and infection,
• More days lost from school.
Connecticut’s Pediatric Dental Health


In 2001, it was reported that 71% of
Connecticut children enrolled in
HUSKY A (Healthcare for UninSured
Kids and Youth), the state’s Medicaid
program for low-income families,
received no dental visit.*


But in 2010, Connecticut rated an “A”
for improving children’s dental health
over a 10-year period.**


What changed?




   * http://www.cthealth.org/wp-content/uploads/2011/04/Oral-Health-Report-2001.pdf
   ** http://www.pewtrusts.org/uploadedFiles/Cost_of_Delay_web.pdf
Inadequate Access to Basic Dental Care


Historically, children enrolled in
HUSKY A have had difficulty
accessing dental care due, in large
part, to:


• Low Medicaid reimbursement rates
  that discouraged private providers
  from program participation
• Cumbersome Medicaid
  administration
The Impact of Changes


Based on a 2008 lawsuit settlement
agreement, program administration
improved and reimbursement rates
increased, moving closer to private
insurance rates.
                                      Image or Chart

What was the impact of these
changes on utilization rates and
private dentist participation?
Making Progress


• Twice as many low-income children
  received dental treatment in 2011
  compared with 2006.
• Private provider participation more
  than doubled between 2006 and
  2010.                                  Image or Chart
• An increase in services utilized was
  seen in nearly all 169 towns, but
  especially in the 10 cities with the
  highest populations of children
  enrolled in HUSKY A.
Cities with the Greatest Need


The ten cities with the highest concentration of HUSKY A children have the greatest
need for dental services. In 2011, the utilization rates for continuously enrolled
children averaged 70 percent across these cities, a rate higher than that of privately
insured children. Those cities are:


     • Hartford                                    • New Haven
     • New Britain                                 • Meriden
     • East Hartford                               • Waterbury
     • New London                                  • Windham
     • Bridgeport                                  • Norwich
Participation from Dentists


The strong response of private
dentists is most likely the result of
increased Medicaid reimbursement
rates.

The positive collaboration between      Image or Chart
advocates, the Department of Social
Services, and the Connecticut State
Dental Association, and the
contributions of Medicaid program
administrative improvements, have
also added to the increase in private
dentist participation.
Recommendations to Maintain this Participation


To ensure that low-income children continue to
have access to oral health services, action is
required:


• HUSKY A reimbursement rates must be
  increased periodically to offset the
  increasing cost of providing dental services.
                                                  Image or Chart
• HUSKY A dental program administration
  and management must continue to be
  streamlined to encourage private dentist
  participation.
Learn More


Read our brief, Impact of Increased Dental Reimbursement Rates on
             HUSKY A-Insured Children: 2006 – 2011.

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Helping Children Get Access to Dental Care - Key Findings and Recommendations

  • 1. The Impact of Increased Dental Reimbursement Rates on Children Enrolled in Medicaid Helping Children Get Access to Dental Care - Key Findings and Recommendations
  • 2. The Consequences of Not Going to the Dentist Well-established research illustrates the consequences of inadequate access to basic dental care for children: • More oral disease, • More dental pain and infection, • More days lost from school.
  • 3. Connecticut’s Pediatric Dental Health In 2001, it was reported that 71% of Connecticut children enrolled in HUSKY A (Healthcare for UninSured Kids and Youth), the state’s Medicaid program for low-income families, received no dental visit.* But in 2010, Connecticut rated an “A” for improving children’s dental health over a 10-year period.** What changed? * http://www.cthealth.org/wp-content/uploads/2011/04/Oral-Health-Report-2001.pdf ** http://www.pewtrusts.org/uploadedFiles/Cost_of_Delay_web.pdf
  • 4. Inadequate Access to Basic Dental Care Historically, children enrolled in HUSKY A have had difficulty accessing dental care due, in large part, to: • Low Medicaid reimbursement rates that discouraged private providers from program participation • Cumbersome Medicaid administration
  • 5. The Impact of Changes Based on a 2008 lawsuit settlement agreement, program administration improved and reimbursement rates increased, moving closer to private insurance rates. Image or Chart What was the impact of these changes on utilization rates and private dentist participation?
  • 6. Making Progress • Twice as many low-income children received dental treatment in 2011 compared with 2006. • Private provider participation more than doubled between 2006 and 2010. Image or Chart • An increase in services utilized was seen in nearly all 169 towns, but especially in the 10 cities with the highest populations of children enrolled in HUSKY A.
  • 7. Cities with the Greatest Need The ten cities with the highest concentration of HUSKY A children have the greatest need for dental services. In 2011, the utilization rates for continuously enrolled children averaged 70 percent across these cities, a rate higher than that of privately insured children. Those cities are: • Hartford • New Haven • New Britain • Meriden • East Hartford • Waterbury • New London • Windham • Bridgeport • Norwich
  • 8. Participation from Dentists The strong response of private dentists is most likely the result of increased Medicaid reimbursement rates. The positive collaboration between Image or Chart advocates, the Department of Social Services, and the Connecticut State Dental Association, and the contributions of Medicaid program administrative improvements, have also added to the increase in private dentist participation.
  • 9. Recommendations to Maintain this Participation To ensure that low-income children continue to have access to oral health services, action is required: • HUSKY A reimbursement rates must be increased periodically to offset the increasing cost of providing dental services. Image or Chart • HUSKY A dental program administration and management must continue to be streamlined to encourage private dentist participation.
  • 10. Learn More Read our brief, Impact of Increased Dental Reimbursement Rates on HUSKY A-Insured Children: 2006 – 2011.