Pennsylvania Medical Assistance : Evaluation of Children ’ s Access to Dental Services
Figure 3 : Proportion of Medical Assistance Children in Managed Care Age 4 to 21 with Developmental Disabilities Who had an Annual Dental Visit from 2005 through 2009
Source : Office of Medical Assistance Programs , Division of Quality Assessment . HealthChoices Performance Trending Reports for 2007 and 2009 . http :// www . dpw . state . pa . us / Resources / Documents / Pdf / AnnualReports / 2009HealthChoicesPerfTrendingReport . pdf and http :// www . dpw . state . pa . us / Resources / Documents / Pdf / AnnualReports / 20 07HealthChoicesTrendRpt . pdf
Dental Provider Participation in Medical Assistance
Source : Office of Medical Assistance Programs , Division of Quality Assessment . HealthChoices Performance Trending Reports for 2007 and 2009 . http :// www . dpw . state . pa . us / Resources / Documents / Pdf / AnnualReports / 2009HealthChoicesPerfTrendingReport . pdf and http :// www . dpw . state . pa . us / Resources / Documents / Pdf / AnnualReports / 20 07HealthChoicesTrendRpt . pdf
Quality of Care The proportion of Medical Assistance children who receive dental sealants is one indicator of quality of care . Figure 4 presents recent trends in the proportion of Medical Assistance children enrolled in a MCO who turned 8 years old and had a protective dental sealant applied to their teeth during the three years prior to the eighth birthday . Between 2005 and 2009 , performance on this measure has improved in five of the six plans for which we have data . 17 In 2009 , the proportion of children reaching the age of 8 who had dental sealants ranged from 27.6 percent at Unison to 56 percent at AmeriHealth .
Figure 4 : Dental Sealants for Medical Assistance Children in Managed Care from 2005 through 2009
In order for children covered by Medical Assistance to receive dental services , their families must be able to find a dentist who accepts Medical Assistance payment . Analysts often use the dental participation rate or the proportion of overall dentists who treat individuals covered by Medical Assistance as an indicator of potential access .
The Total Number of Pennsylvania Dentists Every other year , the Pennsylvania Department of Health ( DOH ) surveys all dentists licensed in Pennsylvania . Based on the findings of its last survey in 2009 , the DOH estimates that there were 6,261 practicing dentists in Pennsylvania in 2009 . 18 However , since the DOH estimates do not include the 398 dentists 19 who were licensed for the first time in Pennsylvania that year , the total number of practicing dentists should be increased to 6,659 .
Pennsylvania Dentists Who Accept Medical Assistance There are two sources of data on the number of dentists who accept Medical Assistance in Pennsylvania : DOH and DPW .
• Pennsylvania DOH asked dentists in the biennial survey discussed above : “ Do you accept any of the following coverage plans : Medicaid , Medicare and Private Insurance ?” Using the data from the survey , DOH estimates that 871 dentists in Pennsylvania accepted Medical Assistance in 2009 . 20
• DPW maintains information on every dentist who is enrolled in Medical Assistance . ( A dentist must be enrolled in Medical Assistance to be paid for providing services for Medical Assistance recipients in either the FFS program or managed care plans . 21 ) DPW prepares separate reports on the number of dentists currently enrolled in Medical Assistance and the number of dentists who received a payment in any given year ( active dentists ). DPW indicates that between May 2009 and April 2010 , there were 1,723 active Medical Assistance dentists in Pennsylvania . 22
22 September / October 2010 • Pennsylvania Dental Journal