Impact of Wisconsin Medicaid Policy Change on Dental Sealant Utilization.

BACKGROUND: In September 2006, Wisconsin Medicaid changed its policy to allow nondentists to become certified Medicaid providers and to bill for sealants in public health settings.

OBJECTIVE: This study examined changes in patterns of dental sealant utilization in first molars of Wisconsin Medicaid enrollees associated with a policy change.

DATA SOURCE: The Electronic Data Systems of Medicaid Evaluation and Decision Support for Wisconsin from 2001 to 2009.

STUDY DESIGN: Retrospective claims data analysis of Wisconsin Dental Medicaid for children aged 6-16 years.

PRINCIPAL FINDINGS: A total of 479,847 children followed up for 1,441,300 person-years with 64,546 visits were analyzed. The rate of visits for sealants by dentists increased significantly from 3 percent per year prepolicy to 11 percent per year postpolicy, and that of nondentists increased from 18 percent per year to 20 percent after the policy change, but this was not significant. Non-Hispanic blacks had the lowest visit rates for sealant application by dentists and nondentists pre- and postpolicy periods.

CONCLUSIONS: The Wisconsin Medicaid policy change was associated with increased rates of visits for dental sealant placement by dentists. The rate of visits with sealant placements by nondentists increased at the same rate pre- and postpolicy change.