ED Visits Spiked After Dental Benefits Were Cut From Medi-Cal
California emergency departments experienced a spike in visits for dental issues in the two years after comprehensive dental benefits for adults were cut from Medi-Cal, according to a study published in Health Affairs, Reuters reports.
Medi-Cal is California's Medicaid program.
Details of Study
For the study, researchers reviewed ED visits among adult Medi-Cal beneficiaries between 2006 and 2011.
Dental coverage for adults was removed from Med-Cal in 2009. However, California eventually reinstated some of the cut benefits, according to lead author Astha Singhal, a PhD candidate at the University of Iowa's Department of Preventive and Community Dentistry and a research assistant at the university's Public Policy Center.
In total, 113,309 adult Medi-Cal beneficiaries made 121,869 trips to the ED for dental problems during the study time period.
For every 100,000 Medi-Cal beneficiaries, there were about:
- 42 ED visits annually before dental benefits were cut from the program; and
- 56 ED visits annually after the benefits were cut.
The researchers estimated that removal of the benefits contributed to an increase of more than 1,800 ED visits for dental health issues annually.
According to the study, the dental policy change particularly affected:
- Blacks, Hispanics and whites;
- Individuals in large metropolitan areas; and
- Younger adults.
Further, the study found that the costs for dental health-related ED visits increased by 68% after Medi-Cal's policy changed in 2009, after adjustment for inflation.
Singhal said that "the major takeaway [from the study] is that there are unintended consequences that need to be evaluated when you make policy decisions."
Meanwhile, senior study author Peter Damiano -- a professor in the University of Iowa's Department of Preventive and Community Dentistry and director of the University's Public Policy Center -- said California likely still paid for some care that adult beneficiaries received in the ED because they often are billed for medical services (Seaman, Reuters, 5/8).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.