Investigating the Effects of Mandating Pediatric Oral Health Services as Essential Health Benefits

项目摘要/摘要 最近的国家医疗改革，包括《平价医疗法案》(ACA)，相对较少关注 尽管口腔健康对整体健康，特别是对儿童的健康很重要，但口腔健康对口腔健康具有重要意义。其中的一个关键因素 改善口腔健康正在扩大获得预防性牙科保健的机会。尽管总体上关注有限，但有 最近的改革有几个方面可能会影响儿童的口腔健康。儿科牙科福利是 被视为18岁及以下儿童私人保险计划的基本健康福利(EHB)。为了满足这一点 基本牙科福利目标州要求通过私人市场销售的计划涵盖口腔护理 作为医疗保险的一部分，或提供具有适当保险的独立牙科计划。没有 要求父母实际购买保险，然而，在独立牙科计划的情况下， 因此，从政策的角度来看，对任务的评价是重要的。此外，医疗补助和 私营市场保险计划需要向患者免费提供一系列预防性服务。 对于10岁及以下的儿童，口腔健康风险评估包括在必要的 预防性服务。在牙科服务方面，许多州也超出了这些最低标准，包括 作为合格健康计划(QHP)的一部分的额外口腔健康服务。这些最近的口腔健康条款 国家医疗改革提供了一个独特的机会来评估国家和州覆盖的效果 关于在全国范围内接受牙科保险和使用预防性牙科服务的规定。 这项拟议的研究将确定18岁以下儿童口腔健康要求对牙齿的影响 关键预防服务的覆盖面和使用情况。这项研究具有很高的创新性，因为它利用了国家 这项政策可能会影响数百万儿童。我们可以了解任务在儿童方面是多么有效。 牙科覆盖面和牙科服务的使用。这项研究的证据将有助于提供有意义的知识 关于与改善儿童口腔健康相关的潜在未来政策，以及可能在更广泛的范围内 成年人口。我们计划评估多种预防牙科措施和牙科治疗。 评估对牙科保险覆盖范围的影响。我们将通过以下方式进一步评估潜在的异构性 种族/族裔、收入水平、父母教育程度和城乡地位。我们将使用一个全国性的 具有代表性的数据集，以实现所提出的特定目标。

Project Summary/Abstract Recent national health reforms, including the Affordable Care Act (ACA), have devoted relatively little attention to oral health despite the importance of oral health to overall health, particularly for children. A key factor in improving oral health is expanding access to preventive dental care. Despite the limited attention overall, there are several aspects of recent reforms that may affect oral health among children. Pediatric dental benefits are treated as an essential health benefit (EHB) for private insurance plans for children 18 and under. To meet this essential dental benefit objective states require that plans sold via private marketplaces either cover oral care as part of medical coverage or that stand-alone dental plans with appropriate coverage be offered. There is no requirement that the parent actually purchases the coverage, however, in the case of stand-alone dental plans, making the evaluation of the mandate important from a policy perspective. Additionally, both Medicaid and private marketplace insurance plans are required to provide a list of preventive services at no cost to patients. For children 10 years of age and younger, oral health risk assessments are included in the list of required preventive services. In terms of dental services, many states also go beyond these minimums and include additional oral health services as part of qualified health plans (QHP). These oral health provisions of recent national health reforms offer a unique opportunity to evaluate the effects of national and state coverage mandates on take-up of dental coverage and use of preventive dental services among US children nationally. The proposed study will identify the effects of oral health mandates for children under age 18 on dental coverage and use of key preventive services. This study is highly innovative as it takes advantage of a national policy potentially affecting millions of children. We can learn how effective mandates are in the context of child dental coverage and use of dental services. Evidence from this study will contribute meaningful knowledge about potential future policies tied to improving oral health among children and potentially among the broader adult population. We plan to evaluate multiple preventive dental measures and dental treatments in addition to assessing the effect on dental insurance coverage. We will further evaluate potential heterogeneity by race/ethnicity, income levels, parental education, and rural/urban status. We will use a nationally representative dataset to accomplish the proposed Specific Aims.