Evaluating oral health care service expansion and travel distances for children living in rural environments

Children in Medicaid/CHIP public coverage programs who reside in rural counties have limited access to dental care services. Shortages of dental professionals in rural areas and long travel distances impede utilization of dental care. Public and private initiatives are attempting to address this crisis. Missourians instituted deregulatory policies and invested in community based initiatives. Using a Medicaid/CHIP claims administrative dataset from 2004-2007, this research explored patterns of utilization and distance travel to assess the impact of these efforts. The number of participating private dental office providers declined over the study period, and the number of children utilizing clinics increased. Trends are being observed within the Medicaid/CHIP dental care market demonstrating clinics are having a replacement effect on private dental providers. It was discovered that the shifting pattern of utilization to public health clinic locations is lowering the overall travel distances for rural families. Clinics were found to have "hub" properties, improving the geographic availability of care to rural children who may have otherwise had to travel long distances. Allowing greater market entry through deregulation could provide states with greater improvements to their public dental health infrastructure.;Keywords: dental care, Medicaid, SCHIP, rural health, geographic access, utilization...