(Press-News.org) A new study suggests that states may not save as much money as anticipated by eliminating adult dental coverage under Medicaid.
The study from University of Iowa researchers looked at California, which decided to end adult dental coverage under Medicaid in mid-2009. Some 3.5 million low-income adults in the Golden State lost dental benefits.
The researchers found those adults made more than 1,800 additional visits annually to hospital emergency departments for dental care after losing the benefit. In all, California spent $2.9 million each year in Medicaid costs for dental care in emergency departments, up from $1.6 million before the state eliminated the adult dental care benefit. That's a 68 percent increase in costs, when factoring inflation.
Since 2010, five states -- Arizona, Massachusetts, Pennsylvania, South Carolina, and South Dakota -- have either curtailed or eliminated adult dental benefits under Medicaid. Other states, notably Illinois and Missouri, are considering some limits to coverage.
"I think the important point here is although the Medicaid dental benefit for adults is optional, savings derived from dropping the benefit are somewhat eaten up by the increased costs from adults seeking dental care in hospital emergency departments," said Astha Singhal, a postdoctoral researcher in the UI College of Dentistry and corresponding author on the paper, published this month in the journal Health Affairs.
Fifteen states, including Iowa, currently offer comprehensive dental benefits for low-income adults.
The states' deliberations come as the federal government, under the Affordable Care Act, will pick up upwards of 90 percent of the Medicaid bill to states that offer dental benefits to adults through 2020. After that, the costs will shift gradually to states.
"We know states are facing difficult budget decisions. This research indicates there may be unintended consequences with patients feeling forced to rely on emergency-room visits ," said Peter Damiano, director of the UI's Public Policy Center and a contributing author on the paper. "Most ERs can't extract teeth or start root canals. They can only prescribe pain medication and/or antibiotics. This may delay treatment but is unlikely to prevent the need for the dental care at some point in the future ."
The study covered 2006 to 2011, meaning that it looked at emergency department use for dental problems in the low-income adult population before and after California eliminated the Medicaid dental benefit. California partially restored the benefit last year. The researchers obtained their data from the Agency for Healthcare Research and Quality, a branch of the U.S. Department of Health and Human Services.
The researchers found there were an additional 4.4 emergency department visits per month for dental problems per 100,000 enrollees after California eliminated the benefit. Viewed annually, there were more than 1,800 added emergency department visits for dental needs by the adult Medicaid population.
Young adults, members of racial/ethnic minority groups, and urban residents were disproportionately affected by the change, the researchers found.
Other states have shown similar increases, according to other analyses.
Oregon saw a doubling of emergency department visits for unmet adult dental needs after eliminating the Medicaid benefit in 2003. It has since restored the benefit. Meanwhile, Maryland experienced a 12 percent increase in the rate of emergency department visits by adults for dental care after dropping the Medicaid benefit in 1993.
"Providing dental coverage facilitates access to dental care, whereas when cutting dental benefits, patients have no option but to go to hospital emergency departments, which are not equipped to treat them appropriately," said Singhal, who has a research appointment in the UI's Public Policy Center.
INFORMATION:
Contributing authors from the UI include Daniel Caplan, Michael Jones, Elizabeth Momany, Raymond Kuthy and Christopher Buresh. Another contributing author, Robert Isman from the California Department of Health Care Services, helped provide data from California's adult dental population.
The UI's Executive Council for Graduate and Professional Students funded the research.
Today's industrial robots are remarkably efficient -- as long as they're in a controlled environment where everything is exactly where they expect it to be.
But put them in an unfamiliar setting, where they have to think for themselves, and their efficiency plummets. And the difficulty of on-the-fly motion planning increases exponentially with the number of robots involved. For even a simple collaborative task, a team of, say, three autonomous robots might have to think for several hours to come up with a plan of attack.
This week, at the Institute for Electrical and ...
WINSTON-SALEM, N.C. - May 27, 2015 - Picture yourself in a medical office, anxiously awaiting your annual flu shot. The nurse casually states, "This won't hurt a bit." But when the needle pierces your skin it hurts, and it hurts a lot. Your expectations have been violated, and not in a good way.
In a study published in the early online edition of the journal PAIN, researchers at Wake Forest Baptist Medical Center have identified through imaging the part of the brain that is activated when a person expects one level of pain but experiences another.
"This finding gives ...
New models developed at the Masonic Cancer Center, University of Minnesota reveal the genes and pathways that, when altered, can cause osteosarcoma. The information could be used to better target treatments for the often-deadly type of cancer.
The new research is published in Nature Genetics.
"Human osteosarcoma tumors are so genetically disordered it is nearly impossible to utilize usual methods to identify the genes associated with them," said first author Branden Moriarty, Ph.D., researcher in the Masonic Cancer Center and the University of Minnesota Medical School's ...
ANN ARBOR--Economically vulnerable families are increasingly willing to take on debt to maintain a basic standard of living--a situation that can put them into a deep financial hole, according to a new University of Michigan study.
Poor families can find it challenging to stay on top of bills to keep the lights on, food on the table and a roof over their head--and they fall into debt, said Kristin Seefeldt, U-M assistant professor of social work and public policy.
"Unfortunately, once in debt, getting out was difficult," she said.
Trying to replace short-term losses ...
Using ever more energetic lasers, Lawrence Livermore researchers have produced a record high number of electron-positron pairs, opening exciting opportunities to study extreme astrophysical processes, such as black holes and gamma-ray bursts.
By performing experiments using three laser systems -- Titan at Lawrence Livermore, Omega-EP at the Laboratory for Laser Energetics, and Orion at Atomic Weapons Establishment (AWE) in the United Kingdom -- LLNL physicist Hui Chen and her colleagues created nearly a trillion positrons (also known as anti-matter particles). In previous ...
ANN ARBOR--For decades, scientists have known that ET-743, a compound extracted from a marine invertebrate called a mangrove tunicate, can kill cancer cells. The drug has been approved for use in patients in Europe and is in clinical trials in the U.S.
Scientists suspected the mangrove tunicate, which is a type of a sea squirt, doesn't actually make ET-743. But the precise origins of the drug, which is also known as trabectedin, were a mystery.
By analyzing the genome of the tunicate along with the microbes that live inside it using advanced sequencing techniques, researchers ...
WASHINGTON -- A national regulatory framework designed to prevent and limit indoor tanning is needed to alleviate the cancer burden and reduce the billions in financial costs from preventable skin cancer, say two Georgetown University public health experts.
In their "Viewpoint" published online today in JAMA, Darren Mays, PhD, MPH, and John Kraemer, JD, MPH, explore a regulatory opportunity--similar to the way toy safety standards were achieved--that could help drive strong, national policies regarding indoor tanning.
According to "The Surgeon General's Call to Action ...
Psychotic experiences were infrequent in the general population, with an average lifetime prevalence of ever having such an episode estimated at 5.8 percent, according to an article published online by JAMA Psychiatry.
Interest in the epidemiologic landscape of hallucinations and delusions has grown because these psychotic experiences (PEs) are reported by a sizable minority of the population. Some have called for more fine-grained analyses of PEs to guide the field.
Researcher John J. McGrath, Ph.D., M.D., of the University of Queensland, Australia, and coauthors examined ...
An Internet-based acne education program that included automated counseling was not better than a standard educational website in improving acne severity and quality of life in adolescents, according to an article published online by JAMA Dermatology.
Acne vulgaris is a chronic inflammatory skin disease that is prevalent among adolescents. Patient education is an important part of managing acne along with medication. However, the effect of patient education on clinical outcomes is not well characterized in dermatology publications.
Researcher April W. Armstrong, M.D., ...
The controversial practice of administering pre-surgery beta-blockers to patients having noncardiac surgery was associated with an increased risk of death in patients with no cardiac risk factors but it was beneficial for patients with three to four risk factors, according to a report published online by JAMA Surgery.
Pre-surgery β-blockade is a widely accepted practice in patients having cardiac surgery. But its use in patients at low risk of heart-related events having noncardiac surgery is controversial because of the increased risk of stroke and hypotension (low ...
