Evaluation of Medicaid Generosity on a State-by-State Basis

Objectives: Medicaid generosity refers to the comprehensiveness of benefits provided and the inclusivity in eligibility for coverage. Though the federal government sets the minimum requirements for Medicaid benefits, how far each states’ Medicaid program extends above those minimum requirements varies on a state-by-state basis. As a result, there is wide variation in each states’ Medicaid program’s generosity. This is especially true for dental benefits for low-income adults, which is an ‘optional’ benefit left to individual states’ discretion. While the states’ variation in Medicaid coverage and payment generosity is a known fact, how these policy decisions affect health, more specifically oral health, are not understood. Most research studies thus far have used an oversimplified classification of benefits to examine their impact on dental care. Moreover, there has not yet been a comprehensive state-by-state metric of dental Medicaid programs generosity and examination of the program’s impact on dental care and oral health. The objective of our research is to develop a generosity measure for Medicaid using a national standard population.
Methods: We have compiled state-year level information on dental benefits covered, annual maximums, copays and reimbursement rates for dental procedures. We will apply these state-level ‘rules’ to data from Medical Expenditure Panel Survey’s (MEPS) national standard population to get an unbiased estimate of generosity.
Results: We have collected data on each state’s covered procedures and reimbursement rates via their fee schedules. This data has allowed us to confirm findings that there are state-by-state variations in dental Medicaid coverage and payment generosities. As each state’s benefits are applied to the MEPS population on a case-by-case basis, we will be able to draw conclusions on an individual state’s overall generosity.
Conclusions: The measure of dental benefits generosity we develop will facilitate future research in examining the impact of policy on oral health.