ADA Health Policy Institute's methodology overestimates spatial access to dental care for publicly insured children

This article discusses the sources of overestimation of spatial access as recently provided by the Health Policy Institute (HPI) of the American Dental Association.

Sources of overestimation of access included estimation of Medicaid participation and capacity and limitations of the access measurement approach.

While the HPI analysis used a 30% Medicaid acceptance rate for Florida, 10.2% of dentists accepted ≥100 Medicaid patients in 2015. The nationwide median number of Medicaid-enrolled children per provider ranges from 36 (Nebraska) to 265 (Florida). HPI estimated that 94% of publicly insured children in Georgia lived within 15 minutes of participating dentists. More rigorous modeling for access estimated that 23% of the total child population do not have access within the state access standards in Georgia.

The estimates provided by HPI substantially overestimate access for children with public insurance. The overestimation comes from both the data limitations and the shortcomings of the methodology employed.