Semester

Spring

Date of Graduation

2022

Document Type

Thesis

Degree Type

MS

College

School of Dentistry

Department

Orthodontics

Committee Chair

Peter Ngan

Committee Member

Chris Martin

Committee Member

Khaled Alsharif

Abstract

Background and Objectives: Medicaid is a federal and state insurance program aimed at helping economically disadvantaged individuals and families with gaining access to health care. Lack of provider participation in the Medicaid program leaves many Medicaid-eligible individuals with the inability to obtain certain medical services, such as orthodontic care. The objective of this study was to use an electronic survey to better understand the beliefs and behaviors of orthodontists in regard to participation in the Medicaid program, and to determine if differences exist between Medicaid providers and non-Medicaid providers. Experimental Design and Methods: Survey: Requests to participate in an electronic survey were submitted to private practicing orthodontists located in Ohio, Pennsylvania and West Virginia (n = 580). Contact information was obtained from the member directory listed on the American Association of Orthodontists (AAO) website. Participants’ responses were categorized based on Medicaid participation; current, former, or never accepted. Results: One hundred nine practitioners responded to the survey (19%). A total of 58 practitioners currently accepted Medicaid patients, 13 formerly accepted Medicaid patients, and 39 had never accepted Medicaid patients. All three groups cited low fees as a major deterrent to participating in the Medicaid program. More providers in the state of West Virginia accept Medicaid patients than those in Pennsylvania and Ohio. Providers who felt confident with their own and their administrative staff’s ability to navigate the Medicaid system participated in the Medicaid program in higher numbers than those that felt less confident. There were no significant differences in perceptions of Medicaid patient’s compliance in appointment keeping, breakage of appliances or oral hygiene among the different Medicaid participation statuses. Conclusions: Fee reimbursement, reimbursement schedule, and lack of confidence in navigating the Medicaid system are major barriers to orthodontic provider participation.

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