Adult Oral Health and Medicaid Value-Added Benefits
Using 2022 data from more than 400,000 Medicaid members in three states, this study evaluated use of adult dental value-added benefits (VABs). Results show members accessed a range of preventive and restorative services; dental VAB use was particularly notable among populations with cardiovascular disease and diabetes.
Medicaid adult dental coverage varies widely across states, with some programs limited to emergency-only benefits. Medicaid managed care plans use VABs to offer benefits not covered by a state, such as adult dental services. This study examined utilization of dental VABs offered through an Elevance Health-affiliated Medicaid plan.
Among dental VAB users, most received preventive services, including exams (89%), x-rays (76%), and cleanings (53%), while many required restorative care such as fillings (25%) and extractions (23%). Utilization was higher among members with chronic conditions and among racial and ethnic groups that often face greater barriers to care. These findings demonstrate how VABs can expand access to comprehensive dental services and help address gaps in adult oral healthcare.
Related Public Policy Research
Medicare Advantage Supplemental Benefits Are Associated with Improved Health Quality
The use of Medicare Advantage (MA) supplemental benefits—in particular, food and transportation benefits—is associated with improved healthcare quality, especially in managing diabetes and cardiovascular conditions. This analysis of dual eligible special needs plan enrollees highlights the importance of maintaining flexibility in offering non-medical benefits to support complex health and social needs.
Pharmacy Benefit Manager Safety Measures for Opioids for Dental Pain
Anyone who takes prescription opioids to manage acute or chronic pain can develop opioid use disorder (OUD), a problematic pattern of opioid use that causes significant impairment or distress. Elevance Health’s CarelonRx pharmacy benefit manager (PBM) implemented a policy in 2020 that has successfully mitigated unnecessary and inappropriate prescribing of opioids for the treatment of dental pain.
Medicare Advantage Supplemental Benefits and Improved Healthcare Use
Under the Medicare Advantage (MA) program, private plans can offer additional benefits not covered by traditional Medicare known as supplemental benefits. This paper examines the association between supplemental benefit use and healthcare utilization among non-dual eligible and dual eligible MA members.