Author: Jacqueline Ryan ThrowerPublisher:
ISBN:
Category :
Languages : en
Pages : 0
Book Description
Impact of Variations in Access to Orthodontic Treatment Among Medicaid Populations: Oregon and Washington Patient Perspective
Author: Jacqueline Ryan ThrowerPublisher:
ISBN:
Category :
Languages : en
Pages : 0
Book Description
THE VARIANCE BETWEEN ELIGIBILITY AND FUNDING FOR MEDICAID PATIENTS SEEKING ORTHODONTIC TREATMENT IN PENNSYLVANIA
Author: Patrick Thomas MoranPublisher:
ISBN:
Category :
Languages : en
Pages : 57
Book Description
Objectives: Medicaid Insurance Provider funding decisions often differ from the orthodontic clinician, assessed by malocclusion indices used for approvals. This study analyzed differences between clinician and insurance, insurance providers, and time of year for funding approval of orthodontic treatment. Since many American orthodontic graduate programs utilize Medicaid access to care as their predominant source, our sample evaluated Temple's University Orthodontic cohort, between January 1st, 2018 and Dec 31st, 2019. Methods: The sample included 1,576 individuals, with 926 insured by Company 2 or Company 3 and the remaining 207 insured by either Company 1, Company 4, Company 5, or Company 6. Malocclusion severity evaluation had an inter-examiner reliability ≥90%, using the Salzmann Evaluation Index, with a score of ≥25 determining treatment need. These scores along with intra and extra oral photographs, a cephalogram and panorex, and an intra oral scan were sent to the Insurance Provider, an employee of the insurance provider received the records submitted and made a funding decision. Results: Company 3 displayed the highest similarity to the orthodontic clinician's assessment, agreeing 69.7% of the time. Company 2 and Company 4 showed the lowest similarity at 39.8% and 33.3% agreement respectively. Company 2 and Company 3 were significantly different from each other in the way they determined eligibility for funding with a P-value of
Improving Access to Oral Health Care for Vulnerable and Underserved Populations
Author: National Research CouncilPublisher: National Academies Press
ISBN: 0309209463
Category : Medical
Languages : en
Pages : 296
Book Description
Access to oral health care is essential to promoting and maintaining overall health and well-being, yet only half of the population visits a dentist each year. Poor and minority children are less likely to have access to oral health care than are their nonpoor and nonminority peers. Older adults, people who live in rural areas, and disabled individuals, uniformly confront access barriers, regardless of their financial resources. The consequences of these disparities in access to oral health care can lead to a number of conditions including malnutrition, childhood speech problems, infections, diabetes, heart disease, and premature births. Improving Access to Oral Health Care for Vulnerable and Underserved Populations examines the scope and consequences of inadequate access to oral health services in the United States and recommends ways to combat the economic, structural, geographic, and cultural factors that prevent access to regular, quality care. The report suggests changing funding and reimbursement for dental care; expanding the oral health work force by training doctors, nurses, and other nondental professionals to recognize risk for oral diseases; and revamping regulatory, educational, and administrative practices. It also recommends changes to incorporate oral health care into overall health care. These recommendations support the creation of a diverse workforce that is competent, compensated, and authorized to serve vulnerable and underserved populations across the life cycle. The recommendations provided in Improving Access to Oral Health Care for Vulnerable and Underserved Populations will help direct the efforts of federal, state, and local government agencies; policy makers; health professionals in all fields; private and public health organizations; licensing and accreditation bodies; educational institutions; health care researchers; and philanthropic and advocacy organizations.
The Effectiveness of Phase 1 Orthodontic Treatment in a Medicaid Population
Author: Jennifer Thomas MirabelliPublisher:
ISBN:
Category :
Languages : en
Pages : 46
Book Description
Access to Care Among Vulnerable Populations Enrolled in Oregon's Medicaid Program
Author: Pooya Shawn Darius NaderiPublisher:
ISBN:
Category : African Americans
Languages : en
Pages : 118
Book Description
Heterogeneous Impact of Medicaid Expansion Program in Oregon and Generalizing Effects to Other States
Author: Samin JalaliPublisher:
ISBN:
Category :
Languages : en
Pages : 0
Book Description
Medicaid is the largest means-tested program in the US. It is crucial to assess how it affects its subscribers. This dissertation provides new evidence of Medicaid’s effect on several outcomes beyond physical health. Specifically, I study the heterogeneity of Medicaid’s effect on self-reported happiness, self-reported depression, and self-reported out-of-pocket medical costs. Using Generalized Random Forest (GRF), a causal Machine Learning method, I estimate the effect of the Oregon's 2008 Medicaid expansion as a non-parametric function of individuals’ characteristics. I find that age, weekly working hours, and urbanicity create considerable heterogeneity in Medicaid’s effects. My results show that the Medicaid coverage causes the older population who work more than 30 hours per week to be happier. It also causes adults living in rural areas to incur less out-of-pocket medical costs; and finally, young adults who work at least several hours per week to be less depressed. My results also shed light on some of the mechanisms through which Medicaid may affect these outcomes. I show that the pent-up healthcare demand among older people, education-related efficient use of health services among young adults, and differential health care competition in urban and rural areas are plausible mechanisms which can explain heterogeneity in Medicaid's effects. To examine what would be the effect of Medicaid beyond the Oregon population, I use the results from Oregon experiment to transport them to another State which has not implemented the Medicaid expansion program yet. I employ two statistical methods such as predicting effects using trained GRF on Oregon data and inverse propensity score weighting. Using these methods I estimate the average effect of Medicaid in the target population. My results can help policymakers to better understand the effect of Medicaid expansion and design targeted public insurance programs.
Treatment Outcomes and Retention in Medicaid and Non-Medicaid Orthodontic Patients
Author: Ashkan GhaffariPublisher:
ISBN:
Category :
Languages : en
Pages :
Book Description
Medicaid orthodontic patients have been shown to miss more appointments and break more appliances than self-pay patients, indicating a greater tendency toward non-compliance. Lack of compliance during the post-treatment phase can be detrimental to retention. The purpose of this study was to determine whether there is a difference in PAR score changes between Medicaid and non-Medicaid patients during and after orthodontic treatment. PAR scores were determined using study models of 43 Medicaid and 39 non-Medicaid patients before and at the end of active treatment, and 24 Medicaid and 42 non-Medicaid patients at the end of treatment and at an average of 13 months post-treatment. PAR scores generally reduce during treatment and will increase if relapse occurs. Rates of PAR score change during and after treatment were compared between Medicaid and non-Medicaid patients using the Mann-Whitney U-test. The mean initial PAR score was greater in the Medicaid group (31.95 versus 23.28; p=0.003) while there was no significant difference found between the two groups for the end of treatment PAR scores (3.22 versus 2.93; p=0.451). The rates of PAR score improvement during treatment (14.07/year versus 12.14/year; p=0.203) and worsening after the removal of orthodontic appliances (2.04/year versus 2.91/year; p=0.872) were found not to differ between the two groups. It was found that the rate of PAR score improvement during treatment did not differ between Medicaid and non-Medicaid patients. During the post-treatment period, the rate of PAR score worsening was also found not to differ.
The Effect of Medicaid Payment Rates on Access to Dental Care Among Children
Author: Thomas C. BuchmuellerPublisher:
ISBN:
Category : Economics
Languages : en
Pages : 0
Book Description
Historically, low Medicaid reimbursement rates have limited the willingness of health care providers to accept Medicaid patients, leading to access problems in many communities. This problem has been especially acute in the case of dental care. We combine data from several sources to examine the effect of payment rates on access to dental care among children on Medicaid and on dentists' participation in the program. The main utilization analysis is based on data from the Survey of Income and Program Participation combined with data on Medicaid payment rates and private market dental fees for the years 2001 to 2010. Conditioning on state fixed effects, we find a modest, but statistically significant, positive relationship between Medicaid payment rates and several measures of dental care utilization. We find a comparable effect in aggregate data reported by state Medicaid programs. The most likely explanation for this result is that higher fees increase the number of dentists that accept Medicaid patients. We test this hypothesis directly using data from annual surveys of dentists conducted by the American Dental Association between 1999 and 2009. The results indicate a positive and statistically significant effect of Medicaid payment rates on whether a dentist treats any publicly insured patients and the percent of the practice's patients who have public insurance. Similar to the utilization results, the magnitude of the effect is relatively small. As a result, the estimates imply that increasing Medicaid payments to the level of private market fees would increase access to care, but the incremental cost of the additional visits induced would be very high.
The Effect of Medicaid Payment Rates on Access to Dental Care Among Children
Author: Thomas C. BuchmuellerPublisher:
ISBN:
Category : Economics
Languages : en
Pages : 48
Book Description
Historically, low Medicaid reimbursement rates have limited the willingness of health care providers to accept Medicaid patients, leading to access problems in many communities. This problem has been especially acute in the case of dental care. We combine data from several sources to examine the effect of payment rates on access to dental care among children on Medicaid and on dentists' participation in the program. The main utilization analysis is based on data from the Survey of Income and Program Participation combined with data on Medicaid payment rates and private market dental fees for the years 2001 to 2010. Conditioning on state fixed effects, we find a modest, but statistically significant, positive relationship between Medicaid payment rates and several measures of dental care utilization. We find a comparable effect in aggregate data reported by state Medicaid programs. The most likely explanation for this result is that higher fees increase the number of dentists that accept Medicaid patients. We test this hypothesis directly using data from annual surveys of dentists conducted by the American Dental Association between 1999 and 2009. The results indicate a positive and statistically significant effect of Medicaid payment rates on whether a dentist treats any publicly insured patients and the percent of the practice's patients who have public insurance. Similar to the utilization results, the magnitude of the effect is relatively small. As a result, the estimates imply that increasing Medicaid payments to the level of private market fees would increase access to care, but the incremental cost of the additional visits induced would be very high.
Subjective Orthodontic Treatment Outcomes in a Medicaid Population
Author: Shelby Jace BeattiePublisher:
ISBN:
Category :
Languages : en
Pages : 47
Book Description
Orthodontic treatment outcomes have traditionally been determined according to objective measures, but some researchers and clinicians have turned their focus to subjective outcome measures, such as oral health-related quality of life (OHQoL) and body image (BI). A randomized clinical trial (RCT) compared the objective outcomes of interceptive (ETX) and comprehensive (CTX) orthodontic treatment in a Medicaid population. The aim of the current study was to compare the subjective treatment outcomes of these two groups. An attempt was made to contact all of the subjects who had completed the RCT. Of 134 subjects, 58 (27 ETX, 31 CTX) completed two questionnaires--one for OHQoL and one for BI. The questionnaire results of the two treatment groups were compared using Student's t-tests. Univariate linear regression analyses were performed to identify socio-demographic and occlusal/skeletal variables that predicted OHQoL and BI scores. Predictors of appointment-keeping were also identified using the same statistical method. Mean overall OHQoL and BI scores were better for the CTX group than the ETX group. Incisor irregularity and anterior dental esthetics at the end of the trial were found to predict long-term OHQoL and BI scores, whereas ethnicity was found to predict failed and late appointment rates. In adolescent patients with Medicaid insurance, comprehensive orthodontic treatment produces long-term subjective outcomes, which are superior to interceptive treatment alone.