Dental Care Access for Young Children With Medicaid: Groundtruthing Online Data and Actual Access in the Chicago...

Many dental clinics reportedly accept Medicaid for young children per online sources, but parents' experiences suggest that this differs from actual access. Recognizing potential differences between reported and realized access, we studied realized dental care access and neighborhood-level barriers to care in the Chicago metro area.

We created a list of Medicaid-accepting dental clinics using the Centers for Medicare and Medicaid Services Insurekidsnow.gov "Find a Dentist" search engine tool. Limited to Coordinated Oral Health Promotion Chicago Cohort Study participants' ZIP Codes (N = 51), research staff called each clinic posing as parents trying to schedule their Medicaid-insured children for appointments. Dental clinic and participant addresses were geocoded; using American Community Survey data, we estimated the population's actual access to Medicaid-accepting clinics and neighborhood-level barriers. We used an Enhanced Two-Step Floating Catchment Area analysis to determine realized access and identify disparities.

Of the 379 dental clinics identified online as taking Medicaid insurance for children, only 240 (63.32%) confirmed accepting Medicaid. The catchment area overall met the Health Professional Shortage Area threshold (1 dentist: 5000 population), indicating adequate access for the Medicaid-insured population. Yet, some southern Chicago/southwestern suburbs had exceptionally poor access (< 1 dental clinic: 10,000 population).

Online data showed many dental clinics accepted Medicaid for children, but our study revealed that realized dental care access varied dramatically, with the fewest clinics in areas with the highest portion of children on Medicaid and the largest socioeconomic barriers. Multilevel change is needed to ensure access to critical dental health services for all.