Abstract
Purpose: The purpose of this manuscript was to conduct a cost analysis of the Miles of Smiles Program, a collaboration between the University of Missouri-Kansas City School of Dentistry and the Olathe School District in Kansas. This preventive program was implemented to improve the access to oral health care for low income children within the school district.
Methods: An inventory list and de-identified patient records were used to determine the costs associated with operating the program to serve 339 elementary school students during the 2008 to 2009 school term. Costs related to equipment, supplies and personnel were included. The costs were then compared to the amount of Medicaid reimbursement obtained for the services provided. Additionally, the cost of operating a similar program, if staffed by dental professionals rather than supervised dental hygiene students, was estimated.
Results: The cost of operating the program during the 2008 to 2009 school term was $107,515.74. The program received Medicaid reimbursement for approximately 1.5% of the total operating cost of and approximately 6.3% of the total billable services, however, challenges with submitting and billing Medicaid claims for the first time contributed to this low rate of reimbursement. If a similar program that utilized dental professionals was implemented and treated the same number of patients, the cost would be approximately $37,529.65 more due to higher expenses associated with personnel and supplies.
Conclusion: The program is not self-sustainable based on Medicaid government-funded insurance reimbursement alone, and therefore continuous external sources of funding or a change in the program design would be necessary for long-term sustainability of the program.
- access to care
- dental hygiene education
- community–based dental education
- dental care for children
- oral healthcare for the underserved
- portable equipment
- school–based oral health
- cost analysis
- dental medicaid program
Footnotes
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Kylie J. Siruta is a Consultant at the University of Missouri-Kansas City School of Dentistry. Cynthia C. Gadbury–Amyot is a Professor and Associate Dean of Instructional Technology & Faculty Development at the University of Missouri-Kansas City School of Dentistry. Dr. Arif Ahmed is an Associate Professor of Health Administration at the Henry W. Bloch School of Management, University of Missouri-Kansas City. Melanie Simmer-Beck, Lorie Holt, and Tanya Villalpando-Mitchell are all Associate Professors, Division of Dental Hygiene at the University of Missouri-Kansas City School of Dentistry.
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This study supports the NDHRA priority area, Health Services Research: Investigate how alternative models of dental hygiene care delivery can reduce health care inequities.
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The Journal of Dental Hygiene Best Paper Award was created this year to recognize the most outstanding research paper published from the previous year (2013). All original research papers published in 2013 were evaluated by a panel of judges, using specific criteria, to make the final selection. This manuscript first appeared in Volume 87, Issue Number 5 of the October 2013 issue of the Journal of Dental Hygiene.
- Copyright © 2014 The American Dental Hygienists’ Association