Assessing the Impact of Increased Medicaid Dental Reimbursement Rates On the Utilization and Access of Dental Services in South Carolina

In January 2000, the South Carolina Medicaid program set new fees at a level such that each procedure would reimburse 75 percent of the dentists at their full, usual, and customary level. This was a stark departure from the usual approach taken, where state Medicaid agencies would approve modest increases in fees --normally a proportion of the full, usual, and customary level. Given that the South Carolina reimbursements were set such that most dentists would pay no financial penalty for filling a time slot with a Medicaid patient instead of a private pay patient, policy makers hoped that dentists would respond to the fee changes. The reform increased the number of: (1) Medicaid children receiving services; (2) services Medicaid children received; and (3) participating dentists, but not the Medicaid load per participating dentist. Consequently, the results indicate that the January 2000 reform had the desired results. It is recommended that South Carolina policy makers consider maintaining their commitment to a Medicaid reimbursement that reflects the 75th percentile of private pay fees for dental procedures.

FEDERAL CONTACT: John Kehoe, 404-562-7983 PIC ID: 7196

PERFORMER: Medical University of South Carolina, Charleston, SC

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