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How Do Providers Respond to Changes in Public Health Insurance Coverage? Evidence from Adult Medicaid Dental Benefits

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  • Thomas Buchmueller
  • Sarah Miller
  • Marko Vujicic

Abstract

This study evaluates how large changes in public health insurance coverage affect provider behavior and patient wait times by analyzing a common type of primary care: dental services. When states expand coverage of dental services to adult Medicaid beneficiaries, dentists' participation in Medicaid increases and dentists see more publicly insured patients. Dentists supply more visits but only modestly increase the amount of time spent working. They achieve this in part by making greater use of dental hygienists. Wait times increase modestly, with the largest increases in wait times observed in states with restrictive scope of practice laws governing dental hygienists.

Suggested Citation

  • Thomas Buchmueller & Sarah Miller & Marko Vujicic, 2016. "How Do Providers Respond to Changes in Public Health Insurance Coverage? Evidence from Adult Medicaid Dental Benefits," American Economic Journal: Economic Policy, American Economic Association, vol. 8(4), pages 70-102, November.
    • Handle: RePEc:aea:aejpol:v:8:y:2016:i:4:p:70-102
    Note: DOI: 10.1257/pol.20150004
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    References listed on IDEAS

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    Cited by:

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    3. Dillender, Marcus & Friedson, Andrew & Gian, Cong & Simon, Kosali, 2019. "Does the healthcare educational market respond to short-run local demand?," Economics of Education Review, Elsevier, vol. 73(C).
    4. Denis Agniel & Jonathan H. Cantor & Johanna Catherine Maclean & Kosali I. Simon & Erin Taylor, 2023. "Insurance Coverage and Provision of Opioid Treatment: Evidence from Medicare," NBER Working Papers 31884, National Bureau of Economic Research, Inc.
    5. Huh, Jason, 2021. "Medicaid and provider supply," Journal of Public Economics, Elsevier, vol. 200(C).
    6. Yingfei Mu & Edward A. Rubin & Eric Zou, 2021. "What’s Missing in Environmental (Self-)Monitoring: Evidence from Strategic Shutdowns of Pollution Monitors," NBER Working Papers 28735, National Bureau of Economic Research, Inc.
    7. Wang, Chao & Sweetman, Arthur, 2020. "Delisting eye examinations from public health insurance: Empirical evidence from Canada regarding impacts on patients and providers," Health Policy, Elsevier, vol. 124(5), pages 540-548.
    8. Guo, Jiapei & Kilby, Angela E. & Marks, Mindy S., 2024. "The impact of scope-of-practice restrictions on access to medical care," Journal of Health Economics, Elsevier, vol. 94(C).
    9. Jeffrey Clemens & Joshua D. Gottlieb & Jeffrey Hicks, 2021. "How Would Medicare for All Affect Health System Capacity? Evidence from Medicare for Some," Tax Policy and the Economy, University of Chicago Press, vol. 35(1), pages 225-262.
    10. Kamyar Nasseh & John R. Bowblis, 2022. "The effect on dental care utilization from transitioning pediatric Medicaid beneficiaries to managed care," Health Economics, John Wiley & Sons, Ltd., vol. 31(6), pages 1103-1128, June.
    11. Neprash, Hannah T. & Zink, Anna & Sheridan, Bethany & Hempstead, Katherine, 2021. "The effect of Medicaid expansion on Medicaid participation, payer mix, and labor supply in primary care," Journal of Health Economics, Elsevier, vol. 80(C).
    12. Colleen M. Carey & Sarah Miller & Laura R. Wherry, 2020. "The Impact of Insurance Expansions on the Already Insured: The Affordable Care Act and Medicare," American Economic Journal: Applied Economics, American Economic Association, vol. 12(4), pages 288-318, October.
    13. Lipton, Brandy J., 2021. "Adult Medicaid benefit generosity and receipt of recommended health services among low-income children: The spillover effects of Medicaid adult dental coverage expansions," Journal of Health Economics, Elsevier, vol. 75(C).
    14. Shooshan Danagoulian & Thomas A. Wilk, 2022. "Locking out prevention: Dental care in the midst of a pandemic," Health Economics, John Wiley & Sons, Ltd., vol. 31(9), pages 1973-1992, September.
    15. Jie Chen & Chad D. Meyerhoefer & Edward J. Timmons, 2024. "The effects of dental hygienist autonomy on dental care utilization," Health Economics, John Wiley & Sons, Ltd., vol. 33(8), pages 1726-1747, August.
    16. Dillender, Marcus & Jinks, Lu & Lo Sasso, Anthony T., 2023. "When (and why) providers do not respond to changes in reimbursement rates," Journal of Public Economics, Elsevier, vol. 217(C).
    17. Boudreaux, Michel & Lipton, Brandy, 2018. "Medicaid Benefit Generosity and Labor Market Outcomes: Evidence from Medicaid Adult Vision Benefits," MPRA Paper 83916, University Library of Munich, Germany.
    18. Michael DiNardi, 2021. "Affordable Care Act Medicaid expansions and the nurse labor market," Southern Economic Journal, John Wiley & Sons, vol. 88(1), pages 367-398, July.
    19. Liam Sigaud & Markus Bjoerkheim & Vitor Melo, 2024. "The Hidden Subsidy of the Affordable Care Act," Papers 2407.07217, arXiv.org.
    20. Bjoerkheim, Markus & Sigaud, Liam & Ampaabeng, Kofi, 2023. "The Effect of the Affordable Care Act's Medicaid Expansion on the Mental Health Of Already-Enrolled Medicaid Beneficiaries," Working Papers 12430, George Mason University, Mercatus Center.
    21. Johanna Catherine Maclean & Ioana Popovici & Elisheva Stern, 2015. "Health Insurance Expansions and Provider Behavior: Evidence from Substance Use Disorder Providers," DETU Working Papers 1510, Department of Economics, Temple University.
    22. Chen, Alice J. & Munnich, Elizabeth L. & Parente, Stephen T. & Richards, Michael R., 2023. "Provider turf wars and Medicare payment rules," Journal of Public Economics, Elsevier, vol. 218(C).

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    More about this item

    JEL classification:

    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • J22 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Time Allocation and Labor Supply
    • J44 - Labor and Demographic Economics - - Particular Labor Markets - - - Professional Labor Markets and Occupations

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