From 2013 to 2015, the statewide percentage of Medicaid children who had at least one dental visit increased 10%; additional data are needed to attribute the increase to recent service delivery changes. While dentist participation is stable, it is low, and OPPAGA found little or no change in participation during the transition from the Prepaid Dental program to statewide Managed Medical Assistance (MMA). Recent data show that 51% of Florida Medicaid dentists served fewer than 100 children in a year, while 21% served fewer than 10.
Compared to Medicaid state reimbursement rates, dental and health plans paid more for dental services. Rates reflect provider contractual arrangements, patient enrollment, geographic differences, and market demand.
Medical loss ratio data and expenditure reports provide insight into spending for dental services. However, different populations, reporting periods, and enrollment information hinders comparison of expenditures across the delivery models. Programmatic differences such as care coordination and expanded adult dental benefits as well as reporting inconsistencies further limit a direct comparison of the two delivery models.
Of the 28 states that are like Florida (with at least 50% of Medicaid recipients enrolled in comprehensive, risk-based managed care), 14 include dental services in managed care programs, 4 deliver services through a prepaid dental program, and 10 use a fee-for-service system.
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