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Title: 0682 - Emergency Department Dental Visits in a New Medicaid Program

Authors:

Susan McKernan (Presenter)
University of Iowa

Astha Singhal, Boston University
Elizabeth Momany, University of Iowa
Peter Damiano, University of Iowa

Abstract:

Objectives: Beginning in May 2014, Iowa’s Medicaid expansion offered dental coverage to low-income adults (aged 19-64) through the new Dental Wellness Plan(DWP). DWP was designed to provide improved access to dental care compared to traditional Medicaid, with a wider provider network, higher reimbursements, and incentived preventive care. These features were hypothesized to contribute to reduced emergency department(ED) visits for non-traumatic dental conditions(NTDCs). This study evaluates trends in ED use during the program’s first 18 months.

Methods: We calculated rates of ED visits for NTDCs among DWP members with comparisons to the traditional adult Medicaid population(5/2014-9/2015). We also calculated rates of ED visits in Medicaid 18 months prior to expansion(11/2012-4/2014) to examine change over time. NTDCs included ICD-9 diagnoses of 521.00-529.00. Rates were calculated as number of ED visits per 1,000 months of member eligibility. We also examined rates of follow-up with a dentist within 60 days following the ED visit in both populations.

Results: From 2014-2015, DWP members had lower rates of ED visits for NTDCs than adults in traditional Medicaid (see Table). Rates of 60-day follow-up with a dentist were higher in DWP compared to traditional Medicaid (36.8% vs. 29.8%, respectively).

Conclusions: Reducing use of EDs for NTDCs offers potential cost savings for dental programs. Innovative program designs may reduce avoidable ED visits.

Table(s):

  Pre-implementation (Nov 2012 - Apr 2014) Post-implementation (May 2014 - Sep 2015)
  Traditional Medicaid Traditional Medicaid Dental Wellness Plan
Age: 19-64 years      
Eligible months 74027 74085 143031
Number of visits 2509 2376 3028
Visits per 1000 months 33.89 32.07 21.17
Percent change   -5%  
Age: 45-64 years      
Eligible months 10925 11041 66685
Number of visits 172 165 730
Visits per 1000 months 15.74 14.94 10.95
Percent change   -5%  

This abstract is based on research that was funded entirely or partially by an outside source:
Iowa Department of Human Services

Disclosure Statement:
The submitter must disclose the names of the organizations with which any author have a relationship, the nature of the relationship, and the clinical or research area involved. The following is submitted: NONE

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