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Increased children's access to fluoride varnish treatment by involving medical care providers: effect of a Medicaid policy change. Health Serv Res 2009 Aug;44(4):1144-56



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Pubmed Central ID




Scopus ID

2-s2.0-68249138309   30 Citations


BACKGROUND: In 2004, the State of Wisconsin introduced a change to their Medicaid Policy allowing medical care providers to be reimbursed for fluoride varnish treatment provided to Medicaid enrolled children.

OBJECTIVE: To determine the extent by which a state-level policy change impacted access to fluoride varnish treatment (FVT) for Medicaid enrolled children.

DATA SOURCE: The Electronic Data Systems of Medicaid Evaluation and Decision Support database for Wisconsin from 2002 to 2006.

STUDY DESIGN: We analyzed Wisconsin Medicaid claims for FVT for children between the ages of 1 and 6 years, comparing rates in the prepolicy period (2002-2003) to the period (2004-2006) following the policy change.

PRINCIPAL FINDINGS: Medicaid claims for FVT in 2002-2003 totaled 3,631. Following the policy change, claims for FVT increased to 28,303, with 38.0 percent submitted by medical care providers. FVT rates increased for children of both sexes and all ages, rising from 1.4 per 1,000 person-years of enrollment in 2002-2003 to 6.6 per 1,000 person-years in 2004-2006. Overall, 48.6 percent of the increase in FVT was attributable to medical care providers. The largest increase was seen in children 1-2 years of age, among whom medical care providers were responsible for 83.5 percent of the increase.

CONCLUSIONS: A state-level Medicaid policy change was followed by both a significant involvement of medical care providers and an overall increase in FVT. Children between the ages of 1 and 2 years appear to benefit the most from the involvement of medical care providers.

Author List

Okunseri C, Szabo A, Jackson S, Pajewski NM, Garcia RI


Christopher Okunseri DDS,MS Associate Professor and Director in the Clinical Services department at Marquette University
Aniko Szabo PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Cariostatic Agents
Child, Preschool
Fluorides, Topical
Health Personnel
Health Policy
Health Services Accessibility
Program Evaluation
Retrospective Studies
United States
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a