Medicaid Adult Dental Benefit Forecasting Tool

Published 06/04/2021

Comprehensive adult dental coverage expands access to oral health care, namely preventive care, and has the potential to improve overall health outcomes for patients and reduce costs of care. Medicaid also serves as a revenue source that enables clinics to increase capacity and broaden their scope of care. That is why the state of Virginia expanded their Medicaid program to include a comprehensive adult dental benefit, effective July 1, 2021. In order to understand the impact of this new benefit, the CareQuest Institute created an interactive tool designed for oral health providers to evaluate the potential impact of existing and new patients covered under the Medicaid adult dental benefit on their practices. The tool enables providers to determine the potential financial impact and additional revenue the benefit could have on their practice to guide decision making about capacity.

Note: This tool was created using the Virginia’s Medicaid dental benefit and should be used by providers in the state but may also be used by providers in other states for case-study comparisons.

Key Takeaways:

  • This tool is designed to give oral health providers the ability to forecast practice capacity and revenue from existing patients with change in coverage who will be newly eligible for coverage as well as revenue from new patients with first-time dental coverage.
  • The tool includes a user guide that walks providers through how to effectively use the tool in a few simple steps. Additionally, the tool itself can be downloaded, manipulated with practice-level patient and procedure data and estimated revenue projections will automatically be calculated.

This tool was developed in collaboration with Virginia Health Catalyst.