title: Impact of fee increases on dental utilization rates for children living in Connecticut and enrolled in Medicaid.
abstract: BACKGROUND
  In 2008, Connecticut's Medicaid program administration increased children's dental fees to match approximately the 70th percentile of what the market fees were for dental care in 2005. These Medicaid program changes occurred at the same time as a national economic recession, which took place from 2007 through 2009.
  
  
  METHODS
  The authors obtained Medicaid eligibility, claims, and provider data before and after the fee increase, in 2006 and 2009 through 2012, respectively. Their analysis examined changes in utilization rates, service mix, expenditures, and dentists' participation. The authors qualitatively assessed the general impact of the recession on utilization rate changes.
  
  
  RESULTS
  The Medicaid fee increase, program improvements, and the recession resulted in a dramatic increase in utilization rates. For children continuously enrolled in Medicaid, utilization rates increased from 45.9% in 2006 to 71.6% in 2012. Rates increased across sex, race, ethnicity, and geographic areas. These increased utilization rates eliminated the disparities in access to dental services between children with private insurance and children receiving Medicaid benefits. Children enrolled in Medicaid now have utilization rates that are similar to or higher than privately insured children. Expenditures increased $62 million; this represents less than 1% of 2012 State Medicaid expenditures. Dentist participation increased by 72%. These results suggest that dentists will participate in the Medicaid program if adequately compensated, and low-income families will seek dental services.
  
  
  CONCLUSIONS
  The Medicaid fee increase, program improvements, and the recession had a dramatic impact on reducing disparities in children's access to dental care in Connecticut.
  
  
  CONCLUSIONS
  One solution to the substantial disparities in access to dental care is to increase Medicaid fees to competitive levels.
authors.forename: Tryfon
authors.initials: T
authors.lastname: Beazoglou
authors.forename: Joanna
authors.initials: J
authors.lastname: Douglass
authors.forename: Veronica
authors.initials: V
authors.lastname: Myne-Joslin
authors.forename: Patricia
authors.initials: P
authors.lastname: Baker
authors.forename: Howard
authors.initials: H
authors.lastname: Bailit
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003237:Connecticut; D019140:Dental Care for Children / Q000191:economics / Q000706:statistics & numerical data*; D005250:Fees, Dental / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008484:Medicaid / Q000191:economics* / Q000706:statistics & numerical data; D014481:United States; D055815:Young Adult
keywords: Delivery of health care; dental care for children; dental care utilization; dental economics; dental health services; dental insurance