title: The individual and program impacts of eliminating Medicaid dental benefits in the Oregon Health Plan.
abstract: OBJECTIVE
  We determined how elimination of dental benefits among adult Medicaid beneficiaries in Oregon affected their access to dental care, Medicaid expenditures, and use of medical settings for dental services.
  
  
  METHODS
  We used a natural experimental design using Medicaid claims data (n = 22 833) before and after Medicaid dental benefits were eliminated in Oregon in 2003 and survey data for continuously enrolled Oregon Health Plan enrollees (n = 718) covering 3 years after benefit cuts.
  
  
  RESULTS
  Claims analysis showed that, compared with enrollees who retained dental benefits, those who lost benefits had large increases in dental-related emergency department use (101.7%; P < .001) and expenditures (98.8%; P < .001) and in all ambulatory medical care use (77.0%; P < .01) and expenditures (114.5%; P < .01). Survey results indicated that enrollees who lost dental benefits had nearly 3 times the odds (odds ratio = 2.863; P = .001) of unmet dental need, and only one third the odds (odds ratio = 0.340; P = .001) of getting annual dental checkups relative to those retaining benefits.
  
  
  CONCLUSIONS
  Combined evidence from both analyses suggested that the elimination of dental benefits resulted in significant unmet dental health care needs, which led to increased use of medical settings for dental problems.
authors.affiliation: Portland State University, Portland, OR 97207-0751, USA. nwallace@pdx.edu
authors.forename: Neal T
authors.initials: NT
authors.lastname: Wallace
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Carlson
authors.forename: David M
authors.initials: DM
authors.lastname: Mosen
authors.forename: John J
authors.initials: JJ
authors.lastname: Snyder
authors.forename: Bill J
authors.initials: BJ
authors.lastname: Wright
mesh_terms: D000328:Adult; D003729:Dental Care / Q000706:statistics & numerical data*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D008297:Male; D008484:Medicaid / Q000191:economics* / Q000706:statistics & numerical data; D008875:Middle Aged; D009922:Oregon; D012959:Socioeconomic Factors; D013221:State Health Plans / Q000191:economics* / Q000706:statistics & numerical data; D014481:United States