Improving children’s use of care in Oregon

Abstract

Background

Despite lowering financial barriers to oral health care through the Patient Protection and Affordable Care Act, income-related access-to-care disparities remain, especially in Oregon. The authors examined the role of a novel dental care organization, the Willamette Dental Group (WDG), in addressing the nonfinancial barriers to oral health care that keep access-to-care disparities in place.

Methods

This longitudinal observational study used dental claims and enrollment data from the Oregon Health Plan from 2014 through 2021. The primary outcome measures were any dental visit and an examination visit. Enrollees in the Oregon Health Plan aged 0 through 18 years who were members of WDG’s Medicaid population were compared with those in the non-WDG Medicaid population. A propensity score subclassification matching method using child-, family-, and community-level variables was used to approximate a randomized study and reduce bias.

Results

The percentage of children who had any dental visit or an examination visit was significantly (P < .001) higher among the WDG members than non-WDG members. Compared with non-WDG programs, a child in the WDG program had a 40% higher chance of having any visit and a 48% higher chance of having an examination visit.

Conclusions

Children enrolled with WDG under the Oregon Health Plan experienced substantially higher oral health care use than children in non-WDG programs. Future studies should focus on the correlation of improved use with oral health outcomes at WDG.

Practical Implications

The innovative practice policies of WDG may lead the way for other large-scale dental delivery programs hoping to improve use for children enrolled in Medicaid. Future studies can benefit from the observational methodology used in this study.