Dentist attitudes toward an annual benefit maximum in Iowa's adult Medicaid program

Objectives

The Dental Wellness Plan (DWP) provides dental coverage for adult Medicaid enrollees in Iowa. In September 2018, a $1000 annual benefit maximum (ABM) was implemented in the DWP program. The aim of this study was to explore private dentists' attitudes toward ABMs and factors associated with ABM attitudes.

Methods

The data source was a mailed survey administered in spring 2019 to all private practice dentists in Iowa. The two dependent variables were (1) attitude toward the $1000 ABM and (2) attitude toward any ABM generally. Independent variables included demographic and practice-related factors, and participation in and attitudes toward the DWP. Descriptive, bivariate, and multivariable analyses were conducted.

Results

While over half (56%) of providers reported a positive attitude toward “Any ABM,” less than half (40%) reported a positive attitude toward the “$1000 ABM.” Attitudes toward both “$1000 ABM” and “Any ABM” were significantly and positively associated with attitudes toward DWP overall and toward DWP structure. Independent variables that were significantly associated with both the “$1000 ABM” and “Any ABM” included overall attitude toward the DWP, attitude toward DWP structure, and practice busyness.

Conclusions

Utilizing an ABM, particularly one set at $1000 for a Medicaid program, elicits mixed attitudes among dentists. Future research should evaluate the impact of Medicaid ABMs on long term dentist participation and patient's ability to receive needed care.