Michigan Medicaid's Healthy Kids Dental program: an assessment of the first 12 months.
BACKGROUND
In 2000, Michigan's Medicaid dental program initiated Healthy Kids Dental, or HKD, a demonstration program offering dental coverage to Medicaid-enrolled children in selected counties. The program was administered through a private dental carrier at private reimbursement levels. The authors undertook a study to determine the effect of these changes.


METHODS
The authors obtained enrollment and utilization data for four groups: children covered in the first 12 months of HKD in 22 counties, children with private dental coverage in the same 22 counties in the same 12 months, Medicaid-enrolled children in the same 22 counties for 12 prior months, and Medicaid-enrolled children in 46 counties who were not included in the HKD program at any time. The authors compared access to care, dentists' participation, treatment patterns, patient travel distances and program cost.


RESULTS
Under HKD, dental care utilization increased 31.4 percent overall and 39 percent among children continuously enrolled for 12 months, compared with the previous year under Medicaid. Dentists' participation increased substantially, and the distance traveled by patients for appointments was cut in half. Costs were 2.5 times higher, attributable to more children's receiving care, the mix of services shifting to more comprehensive care and payment at customary reimbursement levels.


CONCLUSIONS
By increasing reimbursement levels and streamlining administration, the HKD demonstration program has shown that substantial improvements can be made to dental access for the Medicaid-enrolled population.


CONCLUSIONS
The findings of this assessment suggest that appropriate attention to administration and payment levels can rapidly improve access for Medicaid-enrolled patients using existing dental personnel. By cooperating with state officials to design a program that addresses multiple issues, dental providers can help create a Medicaid dental program that is attractive to both providers and patients.
Eklund
Stephen A
SA
University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor 48104-3028, USA. saeklund@sph.umich.edu
Pittman
James L
JL
Clark
Sarah J
SJ
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003190:Comprehensive Dental Care / Q000191:economics / Q000706:statistics & numerical data; D019140:Dental Care for Children / Q000191:economics / Q000706:statistics & numerical data; D003815:Dentists / Q000706:statistics & numerical data; D017048:Health Care Costs / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007347:Insurance, Dental / Q000706:statistics & numerical data; D008484:Medicaid; D008824:Michigan; D012051:Reimbursement Mechanisms / Q000706:statistics & numerical data; D014186:Transportation / Q000706:statistics & numerical data; D014481:United States