Pediatric dentists' participation in the California Medicaid program

The purpose of this study was to determine pediatric dentists' participation in the California Medicaid program and investigate barriers to participation.

A 24-question mail-in survey with a follow-up was sent to all pediatric dentists in California with questions including demographics, Medicaid participation, and barriers to participation. Data were analyzed using descriptive statistics, chi-square tests, bivariate analysis, and multivariate logistic regression.

Pediatric dentists returned 364 useable mail-in surveys for a response rate of 70%. Forty-five percent participated in the Medicaid program, one third of which would accept all patients and two thirds of which placed some restriction on their participation. Twenty-five percent of respondents had at least 10% Medicaid patients in their practice, and 25% accepted 6 or more new Medicaid patients per month. Dentists in rural areas were significantly more likely than those in urban or suburban areas to accept a new Medicaid patient (P < .05). Eighty-nine percent of all respondents reported low fees and 82% reported broken appointments as important reasons for not participating or limiting participation.

Participation of California pediatric dentists in Medicaid is low compared to other states that have participation studies. Pediatric dentists in rural areas are most likely to participate. Among the reasons that contribute to California dentists not participating in the Medicaid program, the major ones appear to be low fees, broken appointments, and denial of payment.