Affordable Care Act's Preventive Services Coverage Mandate and Receipt of Fluoride Varnish.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
Read More Add to Saved list
  • Additional Information
    • Source:
      Publisher: American Academy of Pediatrics Country of Publication: United States NLM ID: 0376422 Publication Model: Print Cited Medium: Internet ISSN: 1098-4275 (Electronic) Linking ISSN: 00314005 NLM ISO Abbreviation: Pediatrics Subsets: MEDLINE
    • Publication Information:
      Publication: Elk Grove Village Il : American Academy of Pediatrics
      Original Publication: Springfield, Ill., Thomas.
    • Subject Terms:
      Patient Protection and Affordable Care Act* ; Fluorides, Topical*/therapeutic use ; Fluorides, Topical*/administration & dosage ; Fluorides, Topical*/economics ; Insurance Coverage*/legislation & jurisprudence ; Medicaid*/legislation & jurisprudence; Humans ; Child, Preschool ; Child ; United States ; Infant ; Female ; Male ; Massachusetts ; Preventive Health Services/economics ; Preventive Health Services/legislation & jurisprudence ; Preventive Health Services/statistics & numerical data ; Insurance, Health/legislation & jurisprudence ; Dental Caries/prevention & control ; Cost Sharing/legislation & jurisprudence
    • Abstract:
      Background and Objectives: The Affordable Care Act required private insurers to cover a set of recommended preventive services without cost-sharing. This included coverage of fluoride varnish (FV) applications without cost-sharing for children aged 1 through 5 during medical visits, an evidence-based treatment that prevents tooth decay. We examined if this coverage mandate was associated with more young children receiving FV.
      Methods: Using the Massachusetts All-Payer Claims Database (2014-2018), we examined the likelihood that a privately insured child received FV during a medical visit in a month. We used a difference-in-differences approach, comparing those included in the coverage mandate (aged 1-5) to those excluded from the mandate (aged 6-9), before and after the mandate was enacted (January 2015). We repeated analyses in children with Medicaid because this mandate may have had spillover effects for this population.
      Results: Among children aged 1 through 5 years with private insurance, 1-year postmandate the probability of FV receipt in a month increased 0.16 percentage points more relative to December 2014 (premandate) compared with the change among children aged 6 to 9 years (P < .001; 95% confidence interval = 0.1-0.22). When examining spillover to children with Medicaid, the mandate was not associated with a significant increase in the probability of monthly FV receipt 1-year postmandate.
      Conclusions: This Affordable Care Act mandate requiring coverage of FV without cost-sharing was associated with higher rates of young children receiving FV in medical settings, with the largest result observed among children with private insurance.
      (Copyright © 2024 by the American Academy of Pediatrics.)
    • Grant Information:
      R01 DE028530 United States DE NIDCR NIH HHS
    • Accession Number:
      0 (Fluorides, Topical)
    • Publication Date:
      Date Created: 20241022 Date Completed: 20241031 Latest Revision: 20241113
    • Publication Date:
      20241113
    • Accession Number:
      PMC11524042
    • Accession Number:
      10.1542/peds.2024-066638
    • Accession Number:
      39434700