Medicaid Adult Dental Services and Decreasing Emergency Department Visits

MO HealthNet’s Adult Dental Services:  Decreasing Emergency Department Visits

 See article in the MDA Focus in February 2020

In January 2016, limited Adult Dental coverage began under MO HealthNet, Missouri’s Medicaid plan.  A committed group of stakeholders worked hard to bring about this change to the program that had not covered adult dental since 2005.  So what has this change done?  Here is a look at what the plan has delivered to the participants of the Medicaid program in Missouri:

Claims processed                         938,715

Claim reimbursements                  $76,181,049

Percentage of claims paid to FQHC  81%

These figures demonstrate a great deal of dental care has been delivered to more than 100,000 adults covered by MO HealthNet since 2016.    MO HealthNet has seen a drop in emergency department (ED) visits for Non-traumatic Dental Needs (NTDN) since 2016, as well.  In 2014, it was estimated that Missouri spent more than $17 million a year on unnecessary and non-productive visits to the emergency department for “toothaches.”   The chart for these visits (below) shows a steady decline from January 2016 until June 2019 (a 42% decline). 

There has also been a steady decrease in the number of opioid prescriptions written by physicians in the ED for pain from NTDVs.   Here is the chart for prescriptions:

Even with limited data, it is clear Adult Dental coverage has had a positive effect!