Florida Medicaid HMO Does Not Improve Children's Dental Care, Study Says

Main Category: Dentistry
Also Included In: Medicare / Medicaid / SCHIP
Article Date: 03 Aug 2006 - 17:00 PDT

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The number of low-income Miami-Dade County children who received dental care funded by Medicaid dropped 40% in the first year of a pilot project enacted by Florida Gov. Jeb Bush (R), according to a University of Florida Institute for Child Health Policy study, the Miami Herald reports. The pilot program was part of Bush's 2004 "campaign to contain ever-soaring Medicaid costs by turning to the private sector to manage care," the Herald reports. The program also aimed to improve access to dental care for about 200,000 children and reduce fraud. For the program, the state contracted with Atlantic Dental to provide dental coverage through an HMO. Dentists are paid about $4.25 per month per child for all basic treatment. The Institue for Child Health Policy was hired to study the program's effectiveness. According to the report, which covers a 365-day period that ended June 30, 2005, 22% of eligible children visited the dentist, compared with 37% under the old fee-for-service program. More than 57,000 children visited a dentist during the last year of fee-for-service, compared with 27,000 who visited under the HMO program, the report finds. The report also finds that the number of participating dentists declined from 669 to 251. Forty-six percent of participating dentists who responded to the survey said they were "very dissatisfied" with the program, and 11% said they were "dissatisfied." Sixty-seven percent of dentists and 42% of families said they experienced problems referring children to specialists. The value of services provided during the first year of the HMO was $2.1 million, down from $15.9 million during the previous year under the fee-for-service program, the report finds. The report and Atlantic Dental "both suggest dentists may not be reporting all the care they provide, because they have no financial motive to do so since they've been paid," the Herald reports. Marcio Cabrera, director of Atlantic Dental, said there were positives in the report. For example, a survey of 400 family members finds that about 60% of children visited a dentist at least once during the previous six months, and 80% said they had no difficulty finding a dentist with whom they were satisfied (Dorschner, Miami Herald, 7/30). State Medicaid Director Tom Arnold said the study includes some positive elements about the program, but he also disputed the study's interpretation of a decline in services under the pilot program, noting that the fee-for-service program could have involved a lot of fraud, thus contributing to higher costs. Arnold on Monday said the state is close to finalizing a two-year extension of its contract with Atlantic Dental to continue to provide services under the pilot program (Dorschner, Miami Herald, 8/1).

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