Many Dentists Turn Down Children On Medicaid/CHIP

Many Dentists Turn Down Children On Medicaid/CHIP

Dentists in the USA are much more likely to offer an appointment to children with private health insurance than those in the combined Medicaid and Children's Health Insurance Program (CHIP) dental program, researchers reported in the journal Pediatrics.

Joanna Bisgaier, MSW, from the Department of Emergency Medicine, University of Pennsylvania, and team set out to determine what impact insurance status might have on a dentist's willingness to arrange an appointment for a child with a fractured front tooth.

Six researchers, pretending to be mothers of a 10-year-old boy, called asking for an urgent dental appointment. They each made two calls, one four weeks after the other. They called a stratified random selection of dental practices on behalf of their supposed child who was enrolled in the states' combined Medicaid and Children's Health Insurance Program (CHIP) dental program. The other half had private Blue Cross dental cover.

Calls were identical except for details on insurance coverage - Private Blue Cross versus Medicaid/CHIP). The researchers worked out what the probability was for each child in getting an appointment, depending on their dental insurance status.

Below are some highlighted results out of 170 paired calls to 85 dental practices, 41 of them participating in the Medicaid program:

• 36.5% of Medicaid/CHIP beneficiaries got an appointment
• 95.4% of privately insured Blue Cross children got an appointment
• Of the dental practices that were enrolled in the Medicaid program, Medicaid/CHIP beneficiaries were 18.2 times more likely to be turned down for an appointment compared to the Blue Cross children

In an Abstract in the journal, the authors wrote:

"Illinois dentists, including those participating in Medicaid, are less likely to see a child for an urgent dental complaint if the child has public versus private dental coverage. These results have implications for developing policies that improve access to oral health care."

The authors believe the following factors may impact on a Medicaid/CHIP beneficiary's chances of having a dental appointment - less patient compliance, burdensome administrative requirements, lower fees, and a negative attitude towards beneficiaries.