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Strengthening the evidence base for maternal and child health programs

New: MCH Best strategies database for sample ESMs

Evidence Tools
MCH Best. NPM 13.2: Oral Health in Childhood

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young girl receiving oral health examMedicaid Reforms

MCH Strategy. Increase the number of dental providers who accept Medicaid through activities such as provider training, increased reimbursements, and other incentives.

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Overview. Medicaid reform (e.g., increased reimbursement paid to providers, recruitment of dentists to participate in Medicaid, administrative changes, health plan incentives) can increase preventive dental care utilization.1

Evidence. Moderate Evidence. Medicaid reforms appear to be effective. Access the peer-reviewed evidence about Medicaid reforms through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. State, provider.

Outcome. Percent of infants and children ages 1 to 17 with a past-year preventive dental visit. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.

Examples from the Field. There are currently 0 ESMs across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy. Access descriptions of these ESMs through the MCH Digital Library. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the strategy “Increase the number of dental providers who accept Medicaid through activities such as provider training, increased reimbursements, and other incentives,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of dental providers accepting Medicaid who provided a child preventive dental visit in the past year.
  • Number of new providers accepting Medicaid.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percentage of dental providers accepting Medicaid who provided a child preventive dental visit in the past year.
  • Percentage of new providers accepting Medicaid.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of children enrolled in Medicaid who had a preventive dental visit in the past year.
  • Number of new providers accepting Medicaid who processed claims.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percentage of children enrolled in Medicaid who had a preventive dental visit in the past year.
  • Percentage of new providers accepting Medicaid who processed claims.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


Reference:

1 Nasseh K, Vujicic M. The impact of Medicaid reform on children's dental care utilization in Connecticut, Maryland, and Texas. Health Serv Res. 2015;50(4):1236-1249.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.