Skip Navigation

Strengthen the Evidence for Maternal and Child Health Programs

Sign up for MCHalert eNewsletter

Evidence Tools
MCHbest. Preventive Dental Visit: Child.

MCHbest Logo

Strategy. Medicaid Reforms (Child)

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

Return to main MCHbest page >>

Overview. Implementing Medicaid reform (e.g., increasing reimbursements paid to oral health providers, recruiting dentists to participate in Medicaid, making administrative changes, adding health plan incentives) can increase preventive oral health care utilization.[1] These reforms address systemic obstacles that limit access to dental care for children enrolled in Medicaid. Higher reimbursement rates can encourage more dental providers to accept Medicaid patients, expanding the available network of care. Streamlined administrative processes reduce time and paperwork burdens on both providers and families. Health plan incentives can promote quality improvement initiatives and reward providers who meet preventive care benchmarks. By creating a more sustainable and accessible dental care infrastructure within Medicaid, these policy-level interventions help ensure that children from families with low incomes receive timely preventive oral health services that support healthy development.

Evidence. Moderate Evidence. Strategies with this rating are likely to work...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Tracking data on provider recruitment and support activities
  • Qualitative feedback from dental providers
  • Engagement data with dental associations and organizations

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Cost. This strategy helps to decrease the financial expenditure incurred by individuals, healthcare systems, and society in general for healthcare services.
  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Policy Development and Enforcement (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy or aligned components.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (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 receiving training on Medicaid policies, billing, and administrative process. (Measures workforce engagement in capacity building)
  • Number of incentives for support resources offered to dental providers to encourage Medicaid participation. (Quantifies strategies to reduce challenges)

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

  • Percent of dental providers trained on Medicaid who report increased knowledge and willingness to participate. (Assesses effectiveness of training)
  • Percent of newly enrolled Medicaid dental providers who receive ongoing support and technical assistance. (Measures retention efforts)

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

  • Number of partnerships established between Medicaid and professional dental organizations to support provider recruitment and training. (Measures collaborative effort)
  • Number of policy changes implemented by Medicaid to streamline provider enrollment and reduce administrative burden. (Assesses systems improvement)
  • Number of children and youth who establish a dental home with a regular Medicaid provider and receive continuity of care. (Measures patient-provider relationships)
  • Number of Medicaid policies for initiatives implemented to sustain dental provider participation and support ongoing network adequacy. (Evaluates long-term systems change)

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

  • Percent of Medicaid dental provider recruitment and training resources tailored to areas with greatest access needs. (Measures focus of efforts)
  • Percent of incentives and support strategies tailored to the needs and priorities of dental providers serving communities with lower incomes. (Assesses responsiveness to provider context)
  • Percent of Medicaid-enrolled children and youth who receive a preventive dental visit from a participating provider. (Measures utilization of expanded access)
  • Percent of Medicaid dental providers who remain enrolled and actively serving Medicaid beneficiaries over time. (Measures long-term engagement)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

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

References

1 Nasseh K, Vujicic M. 2015. The impact of Medicaid reform on children’s dental care utilization in Connecticut, Maryland, and Texas. Health Services Research 50(4):1236–1249. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4545356

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.