Estimating the Cost Savings of Preventive Dental Services Delivered to Medicaid-Enrolled Children in Six Southeastern States

Abstract

Objective: To quantify the impact of multiyear utilization of preventive dental services on downstream dental care utilization and expenditures for children.

Data sources/study setting: We followed 0.93 million Medicaid-enrolled children who were 3-6 years old in 2005 from 2005 to 2011. We used Medicaid claims data of Alabama, Georgia, Mississippi, North Carolina, South Carolina, and Texas.

Study design: We clustered each state's study population into four groups based on utilization of topical fluoride and dental sealants before caries-related treatment using machine learning algorithms. We evaluated utilization rates and expenditures across the four groups and quantified cost savings of preventive care for different levels of penetration.

Data extraction method: We extracted all dental-related claims using CDT codes.

Principal findings: In all states, Medicaid expenditures were much lower for children who received topical fluoride and dental sealants before caries development than for all other children, with a per-member per-year difference ranging from $88 for Alabama to $156 for Mississippi.

Conclusions: The cost savings from topical fluoride and sealants across the six states ranged from $1.1M/year in Mississippi to $12.9M/year in Texas at a 10 percent penetration level. Preventive dental care for children not only improves oral health outcomes but is also cost saving.

Keywords: Dental care; Medicaid; cost savings; pediatrics; prevention policy.

Figure 1

Illustrative Utilization Patterns Represented as Markov Renewal Process Note. The numbers on each arrow are the transition probability and the average interevent time in years in parentheses. The network graph summarizes 90 percent of the volume of encounters; edges with transition probabilities <.1 were omitted for ease of interpretation.