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

调查强制儿童口腔健康服务作为基本健康福利的效果

• 批准号: 9888398
• 负责人: Dan Shane
• 金额: $ 15.45万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9888398
• 关键词: 10 year old; Academic achievement; Adolescent; Adult; Affect; Affordable Care Act; Age; Attention; Child; Childhood; Chronic; Data Set; Dental; Dental Care; Dental Insurance; Dental caries; Dentists; Diabetes Mellitus; Education; Enrollment; Ethnic Origin; Evaluation; Excision; Future; Goals; Health; Health Benefit; Health Care Reform; Health Insurance; Health Services; Healthcare; Heart Diseases; Heterogeneity; Income; Individual; Insurance Coverage; Intervention; Knowledge; Learning; Link; Measures; Medicaid; Medical; National Health Insurance; Oral health; Parents; Patients; Periodontal Diseases; Personal Satisfaction; Policies; Population; Preventive; Preventive dental care; Preventive service; Privatization; Provider; Public Policy; Race; Research; Risk; Risk Assessment; Rural; Services; Time; Tooth Loss; Tooth structure; United States National Institutes of Health; aged; care systems; child services; cost; health care availability; health plan; improved; innovation; insurance plan; oral care; prevent; psychosocial; young adult

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.

项目总结/摘要 最近的国家医疗改革，包括《平价医疗法案》（ACA）， 尽管口腔健康对整体健康，特别是对儿童的健康很重要，的关键因素 改善口腔健康扩大了预防性牙科保健的可及性。尽管整体关注有限， 最近的改革有几个方面可能会影响儿童的口腔健康。儿童牙科福利是 作为18岁及以下儿童的私人保险计划的基本健康福利（EHB）。满足这一 基本牙科福利目标州要求通过私人市场销售的计划包括口腔护理 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 然而，在独立牙科计划的情况下，要求父母实际购买保险， 从政策角度重视对任务的评价。此外，医疗补助和 私人市场保险计划必须向患者免费提供一系列预防服务。 对于10岁及以下的儿童，口腔健康风险评估包括在所需的 预防服务。在牙科服务方面，许多州也超过了这些最低标准，包括 作为合格健康计划（QHP）的一部分，提供额外的口腔健康服务。这些口腔卫生规定最近 国家卫生改革提供了一个独特的机会来评估国家和州覆盖的效果 在全国范围内，美国儿童接受牙科保险和使用预防性牙科服务。 这项拟议的研究将确定18岁以下儿童口腔健康指令对牙科的影响。 主要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，因为它利用了一个国家 可能影响数百万儿童的政策。我们可以了解到，在儿童问题上， 牙科保险和使用牙科服务。这项研究的证据将有助于有意义的知识 关于未来可能的政策，以改善儿童的口腔健康，并可能在更广泛的 成人人口。我们计划评估多种预防性牙科措施和牙科治疗， 评估对牙科保险的影响。我们将进一步评估潜在的异质性， 种族/民族、收入水平、父母教育和农村/城市地位。我们将在全国范围内 代表性数据集，以实现拟议的具体目标。