Improving access for Medicaid-insured children: Focus on front-office personnel

Background-Access to dental services for low-income children is limited. Fr ont-office personnel paly a role regarding dentists' participation in the M edicaid program. Methods. Subjects (N = 24) represented general dental offices in Spokane Co unty, Wash., and included participants and nonparticipants in the Access to baby and Child Dentistry, or ABCD, program, a dental society/community pro gram aimed at expanding dental services provided to Medicaid-insured childr en. The authors stratified the participants according to the number of clai ms their practices submitted to Medicaid for ABCD children: non-ABCD, low-A BCD and high-ABCD. Five two-hour focus group sessions were conducted to det ermine participants' beliefs about, attitudes toward and experiences in ser ving this population. Results. The authors' data analysis consisted of a comprehensive content re view of participants' responses from transcripted audiotapes. They synthesi zed frequently mentioned concepts and ideas into relevant themes. The major factors affecting practices' participation in Medicaid were office policy on seeing Medicaid-insured patients; staff members' personal connection to Medicaid-insured patients; staff members' attitudes about Medicaid-insured patients; and staff members' perceptions of Medicaid-insured patients' barr iers to care. Conclusions-The data suggest that factors affecting dentists' participation in the Medicaid program are more complex than the often-stated dissatisfac tions with low reimbursement fees and hassles with paperwork. Clinical Implications. Efforts to increase dentist participation in serving Medicaid-insured patients will continue to be relatively ineffective until many of the concerns raised by this study's subjects are better understood and addressed.