Medicare Advantage and its Impact on Oral Health Equity among Older Adults

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Project Summary/Abstract Despite the great need for oral healthcare access, many older adults rely on traditional fee -for-service (FFS) Medicare, which does not provide routine dental benefits. The need for oral healthcare services is especially critical for older adults who are racial/ethnic minorities and those who are economically-disadvantaged, as these groups display significantly poorer oral health than their counterparts. Medicare Advantage (MA) health plans are available to U.S. seniors as an alternative to FFS Medicare health plans. MA plans offer access to more comprehensive dental benefits than traditional FFS Medicare, and individuals from underserved backgrounds are enrolling in MA at higher rates than other demographics. Therefore, MA coverage could help facilitate oral health equity among the Medicare-eligible older adult population. Our analyses in this timely, exploratory study will help to determine if there is in fact equity in access to and utilization of oral health services among all demographics of MA enrollees. We will conduct the following aims: Aim 1. Estimate whether traditionally underserved groups, compared to their counterparts, are less likely to have dental coverage in their Medicare Advantage (MA) plans; are less likely to use dental services if covered; and are more likely to receive emergency dental care and receive dental care in a non-dental setting if using covered dental services; Aim 2. Estimate disparities in MA dental coverage, MA covered dental use conditional on MA dental coverage, and emergency dental care and type of dental setting conditional on MA covered dental use after controlling for community-level factors, including among others: county-level measures for the penetration of MA coverage among eligibles, the concentration of MA dental coverage among MA enrollees by race/ethnicity and income, and the market supply of dental providers. The study results will be directly relevant to current, national-level policy decisions around how to improve oral health access to the Medicare population, particularly among underserved groups.