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The Effect of Medicaid Primary Care Provider Reimbursement on Access to Early Childhood Caries Preventive Services
Author(s) -
Herndon Jill Boylston,
Tomar Scott L.,
Catalanotto Frank A.,
Vogel W. Bruce,
Shenkman Elizabeth A.
Publication year - 2015
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12200
Subject(s) - medicaid , reimbursement , receipt , gee , medicine , generalized estimating equation , poisson regression , family medicine , ethnic group , demography , health care , environmental health , statistics , business , population , mathematics , accounting , economics , sociology , anthropology , economic growth
Objective To examine receipt of early childhood caries preventive services ( ECCPS ) in two states' Medicaid programs before and after the implementation of reimbursement to medical primary care providers (M‐ PCP s). Data Sources Enrollment and claims data from the Florida and Texas Medicaid programs for children ≤54 months of age during the period 2006–2010. Study Design We conducted time trend‐adjusted, difference‐in‐differences analyses by using modified Poisson regressions combined with generalized estimating equations ( GEE s) to analyze the effect of M‐ PCP reimbursement on the likelihood that an enrollee had an ECCPS visit after controlling for age, sex, health status, race/ethnicity, geographic location, and enrollment duration. Data Extraction Methods Enrollment data were linked to claims data to create a panel dataset with child‐month observations. Principal Findings Reimbursement to M‐ PCP s was associated with an increased likelihood of ECCPS receipt in general and topical fluoride application specifically in both states. Conclusions Reimbursement to M‐ PCP s can increase access to ECCPS . However, ECCPS receipt continues to fall short of recommended care, presenting opportunities for performance improvement.