Combined medical–dental visits for infants could reduce Medicaid payouts

By Sarah Guy, medwireNews Reporter

An office-based preventive oral health program has resulted in low monthly dental treatment rates for its infant-age Medicaid beneficiary participants, and reduced the likelihood of their hospitalization for dental matters, show US study results.

Analysis of Into the Mouths of Babes (IMB) showed the program has a 32% chance of being ultimately cost-saving to Medicaid, and that this cost-saving likelihood would rise to 95% if Medicaid was willing to pay US$ 2331 (€ 1,797) per hospital episode avoided, report the researchers.

"The pediatric primary care setting provides an alternative site to deliver preventive oral health interventions for preschool-aged children before they develop poor oral health," contend Sally Stearns and colleagues from The University of North Carolina at Chapel Hill, USA, where the IMB program was initiated.

Cost savings would be 100% certain if IMB services could be provided at $ 34 (€ 26) rather than $ 55 (€ 42) per visit, adds the team in the Archives of Pediatrics and Adolescent Medicine.

IMB involves physicians being reimbursed by Medicaid to conduct dental screenings of children aged 3 years or younger, including applying fluoride varnish and counseling parents. The scheme has resulted in improved access to oral healthcare to children, with 18-39% of children in North Carolina having fluoride applications versus a national average of 3%, note the researchers.

While IMB visits cost $ 11 (€ 8) more overall than the equivalent reduced dental treatment payments per person, Stearns et al believe "the benefits may be worth the extra Medicaid payments from a societal perspective that encompasses all the costs of dental caries."

The findings emerge from Medicaid claims data for 209,285 6-month olds who were followed up for an average of 42 months during 2000 to 2006. Compared with making no IMB visits, children who made four or more visits (corresponding to child well-care visits at 6, 9, 12, and 18 months of age) had a significantly lower likelihood of needing dental caries-related treatment (CRT) either at hospital or in a dentist office.

Indeed, compared with their peers who had no IMB visits, children with four or more visits had lower Medicaid payments for hospital episodes for CRT, at $ 2936 versus $ 3051 (€ 2,264 vs 2,353), and dentist office visits for CRT, at $ 334 versus $ 362 (€ 258 vs 279), while costs for dentist office visits with no treatment for CRT were the same.

Overall, monthly dental treatments were very low, with fewer than 2% of children receiving any dental treatment in a given month, remark the researchers.

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