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

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.