Assessing the impact of RI's managed oral health program (RIte Smiles) on access and utilization of dental care among Medicaid children ages ten years and younger.

medicaid programs are particularly interested in dental care because oral health problems, such as dental caries, are more prevalent and severe among children from low-income families. RIte Smiles, Rhode Island’s managed oral health program, was designed to increase access to dental services, promote the development of good oral health behaviors, decrease the need for restorative and emergency dental care, and decrease Medicaid expenditures for oral health care. To achieve these goals, Rhode Island developed a new oral health delivery system, transitioning from a payer of services model to becoming a purchaser of a dental benefit management (DBM) program provided by private insurers. The program was implemented in September 2006 for non-institutionalized RI residents born on or after May 1, 2000, who have no other dental insurance. In the first year of operations (2006), the program enrolled 34,000 Medicaid eligible children ages six years and younger. Since then, children have been aging into the program each year as the cohort becomes another year older. RIte Smiles now enrolls approximately 52,000 children ages birth to 11 years. Medicaid eligible children who do not qualify for RIte Smiles continue to receive Medicaid dental benefits under the traditional fee-for-service program. The State plans to continue transferring Medicaid eligible children into RIte Smiles until all children under 21 are covered by managed care. Managed dental programs have been shown to improve utilization of services as well as provider participation in many states. One of the strategies adopted by RIte Smiles is promoting early and regular preventive dental care along with more active engagement by primary care physicians. Preventive dental care, such as teeth cleanings, dental sealants and fluoride treatments, is beneficial to maintain good oral health status and avert acute and restorative care. The purpose of this paper is to assess the impact of the RIte Smiles Program on: 1) the percentage of Medicaid enrolled children ages ten years and under receiving dental care before and after the inception of the RIte Smiles program, and 2) changes in the distribution of preventive versus treatments services within the eligible population during the study period.