Medicaid managed care plans may be associated with an increase in nontraumatic dental condition–related emergency department visits among pediatric patients.

In a new study, investigators used an event-study difference-in-differences design to examine data from 34,414 nontraumatic dental ED visits among patients aged 17 years and younger who were residents of Florida and enrolled in Medicaid between 2010 and 2014. 

The investigators noted that 29.3% (n = 10,087) of the ED visits occurred in control counties, whereas 70.7% (n = 24,327) occurred in treatment counties, according to results published in JAMA Health Forum.

Control counties were defined as those that adopted the managed care plans between 2004 and 2007, and treatment counties were defined as those that adopted the plans between 2012 and 2013. 

Compared with control counties, treatment counties had a higher rate of nontraumatic dental condition–related ED visits per 100,000 pediatric Medicaid enrollees (132.7 vs 123.5). Further, compared with the number of visits in the preimplementation period, introducing Medicaid managed care plans for dental services was correlated with an 11.3% increase in the number of ED visits for nontraumatic dental conditions within the first 2.5 years of implementation.

The investigators concluded that Medicaid managed care plans may create a barrier to preventable dental conditions in this patient population—representing unintended consequences of adopting the policies. They concluded that Florida and other states that implemented Medicaid managed care plans should consider retaining fee-for-service arrangements.

Researchers used a primary or secondary International Classification of Diseases code to identify which patients visited the ED for nontraumatic dental conditions

A full list of disclosures can be found in the original study.