TY - JOUR
T1 - Patterns in Pediatric Medicaid Dental Claims and Payment Amounts
T2 - An Analysis of Settings and Dental Providers
AU - Mommaerts, Katherine
AU - Roy, Indrakshi
AU - Bonah, Cassandra
AU - Reznicek, Natalie
AU - Muesch Helm, Denise
PY - 2025/3/1
Y1 - 2025/3/1
N2 - OBJECTIVE: To determine the trends in the settings and types of providers that provide oral health services to pediatric patients using Medicaid in Arizona. METHODS: In a retrospective descriptive study, we examined the place of service and provider type of Medicaid-paid dental claims among pediatric patients from January 2016 to December 2019. We analyzed Medicaid reimbursed dental services using dental claims data. RESULTS: More Arizona children aged birth to 21 were treated in health clinics than in private practice/dental support organization settings in 2019 than in 2016. Preventive and minor restorative dental claims were significantly higher in 2019 than in 2016 for pediatric patients in Arizona. Further, there was an increase in dental claims paid to non-dentists, such as dental hygienists and nurse practitioners, in 2019 compared to 2016. CONCLUSIONS: The place of service and provider type are shifting among pediatric Medicaid patients in Arizona. Not only is there a shift from place of service, but preventive and minor restorative dental claims are being filed by more non-dental providers. This reveals the movement towards integrated oral health in primary care for pediatric Medicaid patients in Arizona.
AB - OBJECTIVE: To determine the trends in the settings and types of providers that provide oral health services to pediatric patients using Medicaid in Arizona. METHODS: In a retrospective descriptive study, we examined the place of service and provider type of Medicaid-paid dental claims among pediatric patients from January 2016 to December 2019. We analyzed Medicaid reimbursed dental services using dental claims data. RESULTS: More Arizona children aged birth to 21 were treated in health clinics than in private practice/dental support organization settings in 2019 than in 2016. Preventive and minor restorative dental claims were significantly higher in 2019 than in 2016 for pediatric patients in Arizona. Further, there was an increase in dental claims paid to non-dentists, such as dental hygienists and nurse practitioners, in 2019 compared to 2016. CONCLUSIONS: The place of service and provider type are shifting among pediatric Medicaid patients in Arizona. Not only is there a shift from place of service, but preventive and minor restorative dental claims are being filed by more non-dental providers. This reveals the movement towards integrated oral health in primary care for pediatric Medicaid patients in Arizona.
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M3 - Article
C2 - 40042479
AN - SCOPUS:86000643057
SN - 0090-7421
VL - 54
SP - e49-e55
JO - Journal of Allied Health
JF - Journal of Allied Health
IS - 1
ER -