Provision of fluoride varnish to Medicaid-enrolled children by physicians: the Massachusetts experience

Health Serv Res. 2011 Dec;46(6pt1):1843-62. doi: 10.1111/j.1475-6773.2011.01289.x. Epub 2011 Jul 15.

Abstract

Objectives: To evaluate the impact of a 2008 Medicaid policy in Massachusetts (MA), regarding reimbursing physicians for providing fluoride varnish (FV) to eligible children in medical settings.

Data source: Survey of a sample of primary care physicians in MA.

Study design: Cross-sectional survey of a sample of physicians who provide care to MassHealth (MA Medicaid) enrolled-children.

Dependent variables: history of completed preventive dental skills training, and FV provision.

Independent variables: oral health knowledge, FV-attitudes, and physician and practice characteristics.

Principal findings: Overall, 19 percent of respondents had completed the training required to be eligible to bill for FV provision. Only 5 percent of physicians were providing FV. Most respondents (63 percent) were not familiar with the new policy, and only 25 percent felt that FV should be provided during well-child visits. Most physicians (60 percent) did not feel that the reimbursement rate of U.S.$26/application was sufficient; 17 percent said that they would not provide FV, regardless of payment. Most common barriers to FV provision were a lack of time and logistical challenges.

Conclusions: Our findings suggest that simply reimbursing physicians for FV provision is insufficient to ensure provider participation. Success of this policy will likely require addressing several barriers identified.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Fluorides, Topical*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Insurance, Health, Reimbursement / statistics & numerical data*
  • Massachusetts
  • Medicaid / organization & administration*
  • Oral Hygiene
  • Physicians, Primary Care / statistics & numerical data*
  • United States

Substances

  • Fluorides, Topical