Does increased Medicaid reimbursement result in increased access to care? Dr. Bollen received her degree in Orthodontics and a PhD in Oral Biology from the University of Michigan. She is currently a Professor and Graduate Program Director of the Department of Orthodontics at the University of Washington in Seattle. She is a Diplomate of the American Board of Orthodontics and maintains a private practice in the greater Seattle area. Orthodontic care becomes increasingly more unaffordable for individuals in the lowest socio-economical groups. States provide orthodontic coverage through their Medicaid program for children with severe handicapping malocclusions. However this does not guarantee access to care since acceptance of Medicaid patients depends on the participation of orthodontists. Many orthodontists refuse to accept and treat these patients for a variety of reasons. Reasons for not accepting patients on Medicaid are multiple, but the low reimbursement rates seem to be the greatest obstacle. Increasing reimbursement rates for other dental services have resulted in greater access to care. It is not known if the same is true for orthodontics. The purpose of this proposal is to evaluate if increased Medicaid reimbursement rates increases access to orthodontic services for the underserved. Specific aims: Do higher reimbursement fees of a publicly funded program (Medicaid) result in: -Greater numbers of treated patients? -Greater numbers of participating orthodontists across the state? -Better geographical distribution of participating orthodontists? The specific aims will be addressed by comparing various states across the nation and by evaluating the changes in Washington State during the past 3 years. The Medicaid reimbursement rates are quite different between states. Comparison of provider participation amongst states will be related to each state’s reimbursement level. Washington State provides a unique opportunity since it more than doubled its re- imbursement fees during the summer of 2007. The effects on orthodontist participation and access to care in response to this change have not yet been evaluated. If increased reimbursement results in increased access to orthodontic services, states need to address this issue to improve access to orthodontic treatment for the underserved. The findings related to Medicaid coverage may also apply to other publicly or privately supported dental programs and hence may provide information applicable to other dental insurers. Access to orthodontic care is an issue that needs to be addressed early on. Exposing orthodontic residents to this topic will increase their awareness and may ultimate result in their efforts to increase access to orthodontic care. The ongoing funded research project at the University of Washington will expose the residents at this institution to these issues and may eventually result in increased access to care. To improve the access to orthodontic care, the AAOF put forth a call for proposals last year. This research project was developed in response to this call. Without the obtained AAOF funding, development and execution of this proposal would not have been possible.
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