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The Effect of Medicaid Payment Rates on Access to Dental Care among Children

Author

Listed:
  • Thomas C. Buchmueller

    (Ross School of Business, University of Michigan, Ann Arbor, and NBER)

  • Sean Orzol

    (Mathematica Policy Research)

  • Lara D. Shore-Sheppard

    (Department of Economics, Williams College and NBER)

Abstract

We examine the effect of payment rates on access to dental care among children on Medicaid and on dentists’ participation in Medicaid. Using data from the Survey of Income and Program Participation combined with data on dental fees from 2001 to 2010 and conditioning on state fixed effects, we find a modest positive relationship between Medicaid payment rates and dental care utilization. We test whether higher fees increase the number of dentists accepting Medicaid patients using data from annual surveys of dentists conducted by the American Dental Association between 1999 and 2009. We find a positive, though small, effect of Medicaid payment rates on whether a dentist treats any publicly insured patients and the percentage of the practice’s patients who have public insurance. The estimates imply that increasing Medicaid payments to the level of private market fees would increase access to care, but at a high cost of inducing additional visits.

Suggested Citation

  • Thomas C. Buchmueller & Sean Orzol & Lara D. Shore-Sheppard, 2015. "The Effect of Medicaid Payment Rates on Access to Dental Care among Children," American Journal of Health Economics, MIT Press, vol. 1(2), pages 194-223, Spring.
  • Handle: RePEc:tpr:amjhec:v:1:y:2015:i:2:p:194-223
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    1. Weintraub, J.A. & Stearns, S.C. & Rozier, R.G. & Huang, C.-C., 2001. "Treatment outcomes and costs of dental sealants among children enrolled in Medicaid," American Journal of Public Health, American Public Health Association, vol. 91(11), pages 1877-1881.
    2. Jonathan Gruber & Kathleen Adams & Joseph P. Newhouse, 1997. "Physician Fee Policy and Medicaid Program Costs," Journal of Human Resources, University of Wisconsin Press, vol. 32(4), pages 611-634.
    3. Rosenbach, M.L., 1989. "The impact of Medicaid on physician use by low-income children," American Journal of Public Health, American Public Health Association, vol. 79(9), pages 1220-1226.
    4. Frank Sloan & Janet Mitchell & Jerry Cromwell, 1978. "Physician Participation in State Medicaid Programs," NBER Chapters, in: The Economics of Physician and Patient Behavior, pages 211-245, National Bureau of Economic Research, Inc.
    5. Kenney, G.M. & McFeeters, J.R. & Yee, J.Y., 2005. "Preventive dental care and unmet dental needs among low-income children," American Journal of Public Health, American Public Health Association, vol. 95(8), pages 1360-1366.
    6. Ai, Chunrong & Norton, Edward C., 2003. "Interaction terms in logit and probit models," Economics Letters, Elsevier, vol. 80(1), pages 123-129, July.
    7. Laurence C. Baker & Anne Beeson Royalty, 2000. "Medicaid Policy, Physician Behavior, and Health Care for the Low-Income Population," Journal of Human Resources, University of Wisconsin Press, vol. 35(3), pages 480-502.
    8. Sandra Decker, 2007. "Medicaid physician fees and the quality of medical care of Medicaid patients in the USA," Review of Economics of the Household, Springer, vol. 5(1), pages 95-112, March.
    9. Long, Stephen H. & Settle, Russell F. & Stuart, Bruce C., 1986. "Reimbursement and access to physicians' services under Medicaid," Journal of Health Economics, Elsevier, vol. 5(3), pages 235-251, September.
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    Cited by:

    1. Marianne P. Bitler & Madeline Zavodny, 2014. "Medicaid: A Review of the Literature," NBER Working Papers 20169, National Bureau of Economic Research, Inc.
    2. Sonchak, Lyudmyla, 2015. "Medicaid reimbursement, prenatal care and infant health," Journal of Health Economics, Elsevier, vol. 44(C), pages 10-24.
    3. Pinka Chatterji & Sandra L. Decker & Jason Huh, 2022. "Medicaid physician fees and access to care among children with special health care needs," Review of Economics of the Household, Springer, vol. 20(3), pages 887-919, September.
    4. Johanna Catherine Maclean & Chandler McClellan & Michael F. Pesko & Daniel Polsky, 2023. "Medicaid reimbursement rates for primary care services and behavioral health outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 32(4), pages 873-909, April.
    5. Thomas C. Buchmueller & Sarah Miller & Marko Vujicic, 2014. "How Do Providers Respond to Public Health Insurance Expansions? Evidence from Adult Medicaid Dental Benefits," NBER Working Papers 20053, National Bureau of Economic Research, Inc.
    6. Michael R. Richards & Coady Wing, 2019. "Recruiting and retaining dental labor in federal facilities: Harder than pulling teeth?," Health Economics, John Wiley & Sons, Ltd., vol. 28(11), pages 1356-1369, November.
    7. Pinka Chatterji & Sandra L. Decker & Jason Huh, 2022. "Medicaid physician fees and access to care among children with special health care needs," Review of Economics of the Household, Springer, vol. 20(3), pages 887-919, September.
    8. Thomas Buchmueller & John C. Ham & Lara D. Shore-Sheppard, 2015. "The Medicaid Program," NBER Chapters, in: Economics of Means-Tested Transfer Programs in the United States, Volume 1, pages 21-136, National Bureau of Economic Research, Inc.
    9. Lipton, Brandy J., 2021. "Adult Medicaid benefit generosity and receipt of recommended health services among low-income children: The spillover effects of Medicaid adult dental coverage expansions," Journal of Health Economics, Elsevier, vol. 75(C).
    10. Kamyar Nasseh & John R. Bowblis, 2022. "The effect on dental care utilization from transitioning pediatric Medicaid beneficiaries to managed care," Health Economics, John Wiley & Sons, Ltd., vol. 31(6), pages 1103-1128, June.
    11. Decker, Sandra L. & Lipton, Brandy J., 2015. "Do Medicaid benefit expansions have teeth? The effect of Medicaid adult dental coverage on the use of dental services and oral health," Journal of Health Economics, Elsevier, vol. 44(C), pages 212-225.
    12. Shooshan Danagoulian & Thomas A. Wilk, 2022. "Locking out prevention: Dental care in the midst of a pandemic," Health Economics, John Wiley & Sons, Ltd., vol. 31(9), pages 1973-1992, September.
    13. Thomas Buchmueller & Sarah Miller & Marko Vujicic, 2016. "How Do Providers Respond to Changes in Public Health Insurance Coverage? Evidence from Adult Medicaid Dental Benefits," American Economic Journal: Economic Policy, American Economic Association, vol. 8(4), pages 70-102, November.

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    More about this item

    Keywords

    health economics; economics; health; medicaid; children; dental care; health insurance.;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • J1 - Labor and Demographic Economics - - Demographic Economics

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