The effect of Medicaid primary care provider reimbursement on access to early childhood caries preventive services.

ObjectiveTo examine receipt of early childhood caries preventive services (ECCPS) in two states' Medicaid programs before and after the implementation of reimbursement to medical primary care providers (M-PCPs). Data SourcesEnrollment and claims data from the Florida and Texas Medicaid programs for children 54months of age during the period 2006-2010. Study DesignWe conducted time trend-adjusted, difference-in-differences analyses by using modified Poisson regressions combined with generalized estimating equations (GEEs) to analyze the effect of M-PCP reimbursement on the likelihood that an enrollee had an ECCPS visit after controlling for age, sex, health status, race/ethnicity, geographic location, and enrollment duration. Data Extraction MethodsEnrollment data were linked to claims data to create a panel dataset with child-month observations. Principal FindingsReimbursement to M-PCPs was associated with an increased likelihood of ECCPS receipt in general and topical fluoride application specifically in both states. ConclusionsReimbursement to M-PCPs can increase access to ECCPS. However, ECCPS receipt continues to fall short of recommended care, presenting opportunities for performance improvement.