J Am Dent Assoc. 2017 Jan;148(1):26-32.e2. doi: 10.1016/j.adaj.2016.09.010. Epub 2016 Nov 17.
The availability of dentists to care for Medicaid beneficiaries is a longstanding concern of many families and those who serve them in the dental profession as well as policy makers. Yet, little information beyond the number of enrolled dentists has been reliably determined. The American Dental Association (ADA) Health Policy Institute has called for more nuanced measures that better reflect dentistry's contribution to the care of Medicaid beneficiaries.
The authors calculated percentages of general and pediatric dentists who enrolled in Medicaid, billed Medicaid, and treated Medicaid beneficiaries in each state for which data were available from the ADA's 2008 study, the Association of State and Territorial Dental Directors' 2013 report, and the 2013 federal Web site InsureKidsNow.org. To determine the number of primary dentists available to treat Medicaid beneficiaries, the ADA masterfile list of clinically active dentists was adjusted to remove nonpediatric dental specialists.
The authors determined that the ADA's 2015 analysis of dentists enrolled in Medicaid was the most rigorously assessed source for enrollment but did not report numbers of billing or treating dentists. Increasingly stringent metrics of participation are associated with considerable declines in dentist participation. They found the underlying data sources unreliable, inaccurate, and incomparable within and among states.
The authors concluded that no consistent, comparable, ongoing source of dentist participation in Medicaid exists that reliably provides substantive information to the profession and policy makers.
Dentistry's ability to respond to policymakers' concerns about service to Medicaid beneficiaries depends on the development and implementation of a standardized, reliable, systematic, and ongoing method to measure meaningful participation.
许多家庭以及牙科行业的服务人员和政策制定者长期以来一直关注能够为医疗补助受益人群提供医疗服务的牙医数量。然而，除了注册牙医的数量之外，几乎没有其他可靠的信息。美国牙科协会（ADA）健康政策研究所呼吁采取更细致的措施，以更好地反映牙科对医疗补助受益人群护理的贡献。
作者根据 ADA 2008 年研究、州和地区牙科主任协会 2013 年报告以及 2013 年联邦网站 InsureKidsNow.org 中提供的可获取数据，计算了每个州注册 Medicaid、向 Medicaid 计费和治疗 Medicaid 受益人的普通和儿科牙医的百分比。为了确定可用于治疗 Medicaid 受益人的初级牙医数量，作者对 ADA 临床活跃牙医的主文件列表进行了调整，以剔除非儿科牙科专家。
作者确定，ADA 对 Medicaid 注册牙医的 2015 年分析是评估参与度最严格的来源，但并未报告计费或治疗牙医的数量。参与度的衡量标准越严格，牙医的参与度就会大幅下降。作者发现，基础数据来源不可靠、不准确，并且各州之间以及各州内部也无法进行比较。
作者得出结论，没有一个持续、可比的 Medicaid 牙医参与的来源，能够为该行业和政策制定者提供可靠的实质性信息。
牙科行业能否响应政策制定者对 Medicaid 受益人群服务的关注，取决于制定和实施一种标准化、可靠、系统和持续的方法，以衡量有意义的参与度。
