Threshold analysis of reimbursing physicians for the application of fluoride varnish in young children
Identifieur interne : 000414 ( Istex/Corpus ); précédent : 000413; suivant : 000415Threshold analysis of reimbursing physicians for the application of fluoride varnish in young children
Auteurs : Kristin S. Hendrix ; Stephen M. Downs ; Ginger Brophy ; Caroline Carney Doebbeling ; Nancy L. SwigonskiSource :
- Journal of Public Health Dentistry [ 0022-4006 ] ; 2013-09.
English descriptors
- KwdEn :
- American academy, American association, Annual estimate, Annual probability, Annual rate, Caries, Cavitation, Children years, Claims data, Dataset, Dental caries, Dental home, Dental providers, Dental services, Dentistry, Health care, Health care services, Hendrix, Indiana medicaid, Indiana medicaid claims data, Indiana university, Medicaid, National academy, Oral health, Original model, Pediatric, Pediatric dentistry, Pediatrician, Pediatrics, Provider, Public health, Public health dentistry, Public health dentistry hendrix, Quarterly estimates, Reimbursement, Restorative, Restorative service utilization rates, Restorative services, Restorative services utilization, State health policy, State medicaid programs, Threshold analysis, Uoride, Uoride varnish, Uoride varnish application, Uoride varnish applications, Utilization rates, Varnish, Young children.
- Teeft :
- American academy, American association, Annual estimate, Annual probability, Annual rate, Caries, Cavitation, Children years, Claims data, Dataset, Dental caries, Dental home, Dental providers, Dental services, Dentistry, Health care, Health care services, Hendrix, Indiana medicaid, Indiana medicaid claims data, Indiana university, Medicaid, National academy, Oral health, Original model, Pediatric, Pediatric dentistry, Pediatrician, Pediatrics, Provider, Public health, Public health dentistry, Public health dentistry hendrix, Quarterly estimates, Reimbursement, Restorative, Restorative service utilization rates, Restorative services, Restorative services utilization, State health policy, State medicaid programs, Threshold analysis, Uoride, Uoride varnish, Uoride varnish application, Uoride varnish applications, Utilization rates, Varnish, Young children.
Abstract
Most state Medicaid programs reimburse physicians for providing fluoride varnish, yet the only published studies of cost‐effectiveness do not show cost‐savings. Our objective is to apply state‐specific claims data to an existing published model to quickly and inexpensively estimate the cost‐savings of a policy consideration to better inform decisions – specifically, to assess whether Indiana Medicaid children's restorative service rates met the threshold to generate cost‐savings.
Url:
DOI: 10.1111/jphd.12026
Links to Exploration step
ISTEX:712A07EB12A58DF205DB5A5AC4FEBDE17D524483Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Threshold analysis of reimbursing physicians for the application of fluoride varnish in young children</title><author><name sortKey="Hendrix, Kristin S" sort="Hendrix, Kristin S" uniqKey="Hendrix K" first="Kristin S." last="Hendrix">Kristin S. Hendrix</name><affiliation><mods:affiliation>Children's Health Services Research, Indiana University, IN, Indianapolis, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Dr. Kristin S. Hendrix, 410 W. 10th Street, Suite HS 1020, Indianapolis, IN 46202‐5140. Tel.: 317‐278‐0552; Fax: 317,278 0456; e‐mail: . Kristin S. Hendrix, Stephen M. Downs, and Nancy L. Swigonski are with Children's Health Services Research, Indiana University. Stephen M. Downs and Nancy L. Swigonski are with Regenstrief Institute, Inc. Ginger Brophy is with Truven Health Analytics. Caroline Carney Doebbeling is with MDWise, Inc. Nancy L. Swigonski is with Public Health, Indiana University.</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: kshendri@iu.edu</mods:affiliation></affiliation></author><author><name sortKey="Downs, Stephen M" sort="Downs, Stephen M" uniqKey="Downs S" first="Stephen M." last="Downs">Stephen M. Downs</name><affiliation><mods:affiliation>Children's Health Services Research, Indiana University, Indianapolis, IN, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Regenstrief Institute, Inc., IN, Indianapolis, USA</mods:affiliation></affiliation></author><author><name sortKey="Brophy, Ginger" sort="Brophy, Ginger" uniqKey="Brophy G" first="Ginger" last="Brophy">Ginger Brophy</name><affiliation><mods:affiliation>Truven Health Analytics, IN, Indianapolis, USA</mods:affiliation></affiliation></author><author><name sortKey="Carney Doebbeling, Caroline" sort="Carney Doebbeling, Caroline" uniqKey="Carney Doebbeling C" first="Caroline" last="Carney Doebbeling">Caroline Carney Doebbeling</name><affiliation><mods:affiliation>MDWise, Inc., IN, Indianapolis, USA</mods:affiliation></affiliation></author><author><name sortKey="Swigonski, Nancy L" sort="Swigonski, Nancy L" uniqKey="Swigonski N" first="Nancy L." last="Swigonski">Nancy L. Swigonski</name><affiliation><mods:affiliation>Children's Health Services Research, Indiana University, Indianapolis, IN, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Regenstrief Institute, Inc., Indianapolis, IN, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Public Health, Indiana University, IN, Indianapolis, USA</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:712A07EB12A58DF205DB5A5AC4FEBDE17D524483</idno><date when="2013" year="2013">2013</date><idno type="doi">10.1111/jphd.12026</idno><idno type="url">https://api.istex.fr/document/712A07EB12A58DF205DB5A5AC4FEBDE17D524483/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">000414</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000414</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main">Threshold analysis of reimbursing physicians for the application of fluoride varnish in young children</title><author><name sortKey="Hendrix, Kristin S" sort="Hendrix, Kristin S" uniqKey="Hendrix K" first="Kristin S." last="Hendrix">Kristin S. Hendrix</name><affiliation><mods:affiliation>Children's Health Services Research, Indiana University, IN, Indianapolis, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Dr. Kristin S. Hendrix, 410 W. 10th Street, Suite HS 1020, Indianapolis, IN 46202‐5140. Tel.: 317‐278‐0552; Fax: 317,278 0456; e‐mail: . Kristin S. Hendrix, Stephen M. Downs, and Nancy L. Swigonski are with Children's Health Services Research, Indiana University. Stephen M. Downs and Nancy L. Swigonski are with Regenstrief Institute, Inc. Ginger Brophy is with Truven Health Analytics. Caroline Carney Doebbeling is with MDWise, Inc. Nancy L. Swigonski is with Public Health, Indiana University.</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: kshendri@iu.edu</mods:affiliation></affiliation></author><author><name sortKey="Downs, Stephen M" sort="Downs, Stephen M" uniqKey="Downs S" first="Stephen M." last="Downs">Stephen M. Downs</name><affiliation><mods:affiliation>Children's Health Services Research, Indiana University, Indianapolis, IN, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Regenstrief Institute, Inc., IN, Indianapolis, USA</mods:affiliation></affiliation></author><author><name sortKey="Brophy, Ginger" sort="Brophy, Ginger" uniqKey="Brophy G" first="Ginger" last="Brophy">Ginger Brophy</name><affiliation><mods:affiliation>Truven Health Analytics, IN, Indianapolis, USA</mods:affiliation></affiliation></author><author><name sortKey="Carney Doebbeling, Caroline" sort="Carney Doebbeling, Caroline" uniqKey="Carney Doebbeling C" first="Caroline" last="Carney Doebbeling">Caroline Carney Doebbeling</name><affiliation><mods:affiliation>MDWise, Inc., IN, Indianapolis, USA</mods:affiliation></affiliation></author><author><name sortKey="Swigonski, Nancy L" sort="Swigonski, Nancy L" uniqKey="Swigonski N" first="Nancy L." last="Swigonski">Nancy L. Swigonski</name><affiliation><mods:affiliation>Children's Health Services Research, Indiana University, Indianapolis, IN, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Regenstrief Institute, Inc., Indianapolis, IN, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Public Health, Indiana University, IN, Indianapolis, USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Journal of Public Health Dentistry</title><title level="j" type="alt">JOURNAL OF PUBLIC HEALTH DENTISTRY</title><idno type="ISSN">0022-4006</idno><idno type="eISSN">1752-7325</idno><imprint><biblScope unit="vol">73</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="297">297</biblScope><biblScope unit="page" to="303">303</biblScope><biblScope unit="page-count">7</biblScope><date type="published" when="2013-09">2013-09</date></imprint><idno type="ISSN">0022-4006</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-4006</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>American academy</term><term>American association</term><term>Annual estimate</term><term>Annual probability</term><term>Annual rate</term><term>Caries</term><term>Cavitation</term><term>Children years</term><term>Claims data</term><term>Dataset</term><term>Dental caries</term><term>Dental home</term><term>Dental providers</term><term>Dental services</term><term>Dentistry</term><term>Health care</term><term>Health care services</term><term>Hendrix</term><term>Indiana medicaid</term><term>Indiana medicaid claims data</term><term>Indiana university</term><term>Medicaid</term><term>National academy</term><term>Oral health</term><term>Original model</term><term>Pediatric</term><term>Pediatric dentistry</term><term>Pediatrician</term><term>Pediatrics</term><term>Provider</term><term>Public health</term><term>Public health dentistry</term><term>Public health dentistry hendrix</term><term>Quarterly estimates</term><term>Reimbursement</term><term>Restorative</term><term>Restorative service utilization rates</term><term>Restorative services</term><term>Restorative services utilization</term><term>State health policy</term><term>State medicaid programs</term><term>Threshold analysis</term><term>Uoride</term><term>Uoride varnish</term><term>Uoride varnish application</term><term>Uoride varnish applications</term><term>Utilization rates</term><term>Varnish</term><term>Young children</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>American academy</term><term>American association</term><term>Annual estimate</term><term>Annual probability</term><term>Annual rate</term><term>Caries</term><term>Cavitation</term><term>Children years</term><term>Claims data</term><term>Dataset</term><term>Dental caries</term><term>Dental home</term><term>Dental providers</term><term>Dental services</term><term>Dentistry</term><term>Health care</term><term>Health care services</term><term>Hendrix</term><term>Indiana medicaid</term><term>Indiana medicaid claims data</term><term>Indiana university</term><term>Medicaid</term><term>National academy</term><term>Oral health</term><term>Original model</term><term>Pediatric</term><term>Pediatric dentistry</term><term>Pediatrician</term><term>Pediatrics</term><term>Provider</term><term>Public health</term><term>Public health dentistry</term><term>Public health dentistry hendrix</term><term>Quarterly estimates</term><term>Reimbursement</term><term>Restorative</term><term>Restorative service utilization rates</term><term>Restorative services</term><term>Restorative services utilization</term><term>State health policy</term><term>State medicaid programs</term><term>Threshold analysis</term><term>Uoride</term><term>Uoride varnish</term><term>Uoride varnish application</term><term>Uoride varnish applications</term><term>Utilization rates</term><term>Varnish</term><term>Young children</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract">Most state Medicaid programs reimburse physicians for providing fluoride varnish, yet the only published studies of cost‐effectiveness do not show cost‐savings. Our objective is to apply state‐specific claims data to an existing published model to quickly and inexpensively estimate the cost‐savings of a policy consideration to better inform decisions – specifically, to assess whether Indiana Medicaid children's restorative service rates met the threshold to generate cost‐savings.</div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>uoride</json:string><json:string>medicaid</json:string><json:string>uoride varnish</json:string><json:string>varnish</json:string><json:string>caries</json:string><json:string>restorative services</json:string><json:string>provider</json:string><json:string>cavitation</json:string><json:string>uoride varnish application</json:string><json:string>oral health</json:string><json:string>pediatric</json:string><json:string>hendrix</json:string><json:string>pediatrician</json:string><json:string>threshold analysis</json:string><json:string>indiana medicaid</json:string><json:string>pediatrics</json:string><json:string>american association</json:string><json:string>dataset</json:string><json:string>children years</json:string><json:string>claims data</json:string><json:string>dental home</json:string><json:string>utilization rates</json:string><json:string>annual probability</json:string><json:string>dental providers</json:string><json:string>american academy</json:string><json:string>dentistry</json:string><json:string>health care</json:string><json:string>dental services</json:string><json:string>dental caries</json:string><json:string>quarterly estimates</json:string><json:string>indiana university</json:string><json:string>original model</json:string><json:string>restorative services utilization</json:string><json:string>indiana medicaid claims data</json:string><json:string>restorative service utilization rates</json:string><json:string>state medicaid programs</json:string><json:string>public health dentistry</json:string><json:string>pediatric dentistry</json:string><json:string>uoride varnish applications</json:string><json:string>health care services</json:string><json:string>public health dentistry hendrix</json:string><json:string>state health policy</json:string><json:string>annual rate</json:string><json:string>young children</json:string><json:string>annual estimate</json:string><json:string>national academy</json:string><json:string>public health</json:string><json:string>reimbursement</json:string><json:string>restorative</json:string></teeft></keywords><author><json:item><name>Kristin S. Hendrix PhD</name><affiliations><json:string>Children's Health Services Research, Indiana University, IN, Indianapolis, USA</json:string><json:string>Dr. Kristin S. Hendrix, 410 W. 10th Street, Suite HS 1020, Indianapolis, IN 46202‐5140. Tel.: 317‐278‐0552; Fax: 317,278 0456; e‐mail: . Kristin S. Hendrix, Stephen M. Downs, and Nancy L. Swigonski are with Children's Health Services Research, Indiana University. Stephen M. Downs and Nancy L. Swigonski are with Regenstrief Institute, Inc. Ginger Brophy is with Truven Health Analytics. Caroline Carney Doebbeling is with MDWise, Inc. Nancy L. Swigonski is with Public Health, Indiana University.</json:string><json:string>E-mail: kshendri@iu.edu</json:string></affiliations></json:item><json:item><name>Stephen M. Downs MD</name><affiliations><json:string>Children's Health Services Research, Indiana University, Indianapolis, IN, USA</json:string><json:string>Regenstrief Institute, Inc., IN, Indianapolis, USA</json:string></affiliations></json:item><json:item><name>Ginger Brophy MPl</name><affiliations><json:string>Truven Health Analytics, IN, Indianapolis, USA</json:string></affiliations></json:item><json:item><name>Caroline Carney Doebbeling MD</name><affiliations><json:string>MDWise, Inc., IN, Indianapolis, USA</json:string></affiliations></json:item><json:item><name>Nancy L. Swigonski MD</name><affiliations><json:string>Children's Health Services Research, Indiana University, Indianapolis, IN, USA</json:string><json:string>Regenstrief Institute, Inc., Indianapolis, IN, USA</json:string><json:string>Public Health, Indiana University, IN, Indianapolis, USA</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>oral health</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>fluorides, topical</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>fluoride varnish</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>costs and cost analysis</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>threshold analysis</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>cost‐containment</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Medicaid</value></json:item></subject><articleId><json:string>JPHD12026</json:string></articleId><arkIstex>ark:/67375/WNG-BHH4614N-C</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>Most state Medicaid programs reimburse physicians for providing fluoride varnish, yet the only published studies of cost‐effectiveness do not show cost‐savings. Our objective is to apply state‐specific claims data to an existing published model to quickly and inexpensively estimate the cost‐savings of a policy consideration to better inform decisions – specifically, to assess whether Indiana Medicaid children's restorative service rates met the threshold to generate cost‐savings.</abstract><qualityIndicators><score>7.364</score><pdfWordCount>4572</pdfWordCount><pdfCharCount>29476</pdfCharCount><pdfVersion>1.3</pdfVersion><pdfPageCount>7</pdfPageCount><pdfPageSize>610.651 x 790.254 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractWordCount>66</abstractWordCount><abstractCharCount>484</abstractCharCount><keywordCount>7</keywordCount></qualityIndicators><title>Threshold analysis of reimbursing physicians for the application of fluoride varnish in young children</title><pmid><json:string>23889556</json:string></pmid><genre><json:string>article</json:string></genre><host><title>Journal of Public Health Dentistry</title><language><json:string>unknown</json:string></language><doi><json:string>10.1111/(ISSN)1752-7325</json:string></doi><issn><json:string>0022-4006</json:string></issn><eissn><json:string>1752-7325</json:string></eissn><publisherId><json:string>JPHD</json:string></publisherId><volume>73</volume><issue>4</issue><pages><first>297</first><last>303</last><total>7</total></pages><genre><json:string>journal</json:string></genre><subject><json:item><value>Original Article</value></json:item></subject></host><namedEntities><unitex><date><json:string>2011</json:string><json:string>1997</json:string><json:string>2013-07-02</json:string><json:string>2006</json:string><json:string>9/26/2012</json:string><json:string>2002</json:string><json:string>2007</json:string><json:string>6/16/2013</json:string><json:string>2004</json:string></date><geogName></geogName><orgName><json:string>National Academy for State Health Policy</json:string><json:string>American Academy of Pediatrics</json:string><json:string>American Dental Association</json:string><json:string>American Academy of Pediatric Dentistry</json:string><json:string>American Association of Public Health Dentistry</json:string><json:string>American Association of Public Health Dentistry Threshold</json:string><json:string>U.S. Department of Health and Human Services</json:string><json:string>Indiana University</json:string><json:string>Health Services Research, Indiana University</json:string><json:string>AAP</json:string><json:string>Regenstrief Institute, Inc</json:string><json:string>Children's Oral Health</json:string><json:string>American Association of Public Health Dentistry Despite</json:string><json:string>AAPD</json:string><json:string>Medicaid Medical Advisory Cabinet</json:string><json:string>American Dental Association Council on Scientific Affairs</json:string></orgName><orgName_funder></orgName_funder><orgName_provider></orgName_provider><persName><json:string>Anna M. Hus</json:string><json:string>Stearns</json:string><json:string>Indiana Medicaid</json:string><json:string>Matthew C. Aalsma</json:string><json:string>Marc B. Rosenman</json:string><json:string>Greg Arling</json:string><json:string>Jana S. Smith</json:string><json:string>Carney Doebbeling</json:string><json:string>Andrew W. Goddard</json:string><json:string>Stephen M. Downs</json:string><json:string>Nancy L. Swigonski</json:string><json:string>Kristin S. Hendrix</json:string><json:string>Gwendolyn C. Morrison</json:string><json:string>Caroline Carney</json:string><json:string>Rozier</json:string><json:string>Ginger Brophy</json:string><json:string>Katherine Schwartz</json:string><json:string>Roberta Ambuehl</json:string><json:string>K.M. Yoder</json:string><json:string>Melissa M. WiegandHahn</json:string></persName><placeName><json:string>United States</json:string><json:string>IN</json:string><json:string>USA</json:string><json:string>Indianapolis</json:string></placeName><ref_url></ref_url><ref_bibl><json:string>Lee et al. (2004)</json:string><json:string>Pahel et al.</json:string><json:string>Quiñonez et al.</json:string><json:string>K.S. Hendrix et al.</json:string><json:string>Swigonski et al.</json:string><json:string>Quiñonez et al. (2006)</json:string><json:string>Tang et al. (1997)</json:string><json:string>Brown et al.</json:string><json:string>Briggs et al.</json:string><json:string>Tang et al.</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/WNG-BHH4614N-C</json:string></ark><categories><wos><json:string>1 - social science</json:string><json:string>2 - public, environmental & occupational health</json:string><json:string>1 - science</json:string><json:string>2 - dentistry, oral surgery & medicine</json:string></wos><scienceMetrix><json:string>1 - health sciences</json:string><json:string>2 - clinical medicine</json:string><json:string>3 - dentistry</json:string></scienceMetrix><scopus><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Public Health, Environmental and Occupational Health</json:string><json:string>1 - Health Sciences</json:string><json:string>2 - Dentistry</json:string><json:string>3 - General Dentistry</json:string></scopus></categories><publicationDate>2013</publicationDate><copyrightDate>2013</copyrightDate><doi><json:string>10.1111/jphd.12026</json:string></doi><id>712A07EB12A58DF205DB5A5AC4FEBDE17D524483</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/712A07EB12A58DF205DB5A5AC4FEBDE17D524483/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/712A07EB12A58DF205DB5A5AC4FEBDE17D524483/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/712A07EB12A58DF205DB5A5AC4FEBDE17D524483/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main">Threshold analysis of reimbursing physicians for the application of fluoride varnish in young children</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Publishing Ltd</publisher><availability><licence>© 2013 American Association of Public Health Dentistry</licence></availability><date type="published" when="2013-09"></date></publicationStmt><notesStmt><note type="content-type" subtype="article" source="article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="article"><analytic><title level="a" type="main">Threshold analysis of reimbursing physicians for the application of fluoride varnish in young children</title><title level="a" type="short">Threshold analysis of fluoride varnish reimbursement</title><author xml:id="author-0000" role="corresp"><persName><forename type="first">Kristin S.</forename><surname>Hendrix</surname><roleName type="degree">PhD</roleName></persName><affiliation><orgName>Children's Health Services Research</orgName><orgName>Indiana University</orgName><address><settlement type="city">Indianapolis</settlement><region>IN</region><country key="US">USA</country></address></affiliation><affiliation>Correspondence Dr. Kristin S. Hendrix, 410 W. 10th Street, Suite HS 1020, Indianapolis, IN 46202‐5140. Tel.: 317‐278‐0552; Fax: 317,278 0456; e‐mail: kshendri@iu.edu. Kristin S. Hendrix, Stephen M. Downs, and Nancy L. Swigonski are with Children's Health Services Research, Indiana University. Stephen M. Downs and Nancy L. Swigonski are with Regenstrief Institute, Inc. Ginger Brophy is with Truven Health Analytics. Caroline Carney Doebbeling is with MDWise, Inc. Nancy L. Swigonski is with Public Health, Indiana University.</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Stephen M.</forename><surname>Downs</surname><roleName type="degree">MD</roleName></persName><affiliation><orgName>Children's Health Services Research</orgName><orgName>Indiana University</orgName><address><settlement type="city">Indianapolis</settlement><region>IN</region><country key="US">USA</country></address></affiliation><affiliation><orgName>Regenstrief Institute, Inc.</orgName><address><settlement type="city">Indianapolis</settlement><region>IN</region><country key="US">USA</country></address></affiliation></author><author xml:id="author-0002"><persName><forename type="first">Ginger</forename><surname>Brophy</surname><roleName type="degree">MPl</roleName></persName><affiliation><orgName>Truven Health Analytics</orgName><address><settlement type="city">Indianapolis</settlement><region>IN</region><country key="US">USA</country></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">Caroline</forename><surname>Carney Doebbeling</surname><roleName type="degree">MD</roleName></persName><affiliation><orgName>MDWise, Inc.</orgName><address><settlement type="city">Indianapolis</settlement><region>IN</region><country key="US">USA</country></address></affiliation></author><author xml:id="author-0004"><persName><forename type="first">Nancy L.</forename><surname>Swigonski</surname><roleName type="degree">MD</roleName></persName><affiliation><orgName>Children's Health Services Research</orgName><orgName>Indiana University</orgName><address><settlement type="city">Indianapolis</settlement><region>IN</region><country key="US">USA</country></address></affiliation><affiliation><orgName>Regenstrief Institute, Inc.</orgName><address><settlement type="city">Indianapolis</settlement><region>IN</region><country key="US">USA</country></address></affiliation><affiliation><orgName>Public Health</orgName><orgName>Indiana University</orgName><address><settlement type="city">Indianapolis</settlement><region>IN</region><country key="US">USA</country></address></affiliation></author><idno type="istex">712A07EB12A58DF205DB5A5AC4FEBDE17D524483</idno><idno type="ark">ark:/67375/WNG-BHH4614N-C</idno><idno type="DOI">10.1111/jphd.12026</idno><idno type="unit">JPHD12026</idno><idno type="toTypesetVersion">file://JPHD.JPHD12026.pdf</idno></analytic><monogr><title level="j" type="main">Journal of Public Health Dentistry</title><title level="j" type="alt">JOURNAL OF PUBLIC HEALTH DENTISTRY</title><idno type="pISSN">0022-4006</idno><idno type="eISSN">1752-7325</idno><idno type="book-DOI">10.1111/(ISSN)1752-7325</idno><idno type="book-part-DOI">10.1111/jphd.2013.73.issue-4</idno><idno type="product">JPHD</idno><imprint><biblScope unit="vol">73</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="297">297</biblScope><biblScope unit="page" to="303">303</biblScope><biblScope unit="page-count">7</biblScope><date type="published" when="2013-09"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract style="main"><head>Abstract</head>
Objective
<p>Most state Medicaid programs reimburse physicians for providing fluoride varnish, yet the only published studies of cost‐effectiveness do not show cost‐savings. Our objective is to apply state‐specific claims data to an existing published model to quickly and inexpensively estimate the cost‐savings of a policy consideration to better inform decisions – specifically, to assess whether <hi rend="fc">I</hi>ndiana <hi rend="fc">M</hi>edicaid children's restorative service rates met the threshold to generate cost‐savings.</p>
Methods
<p>Threshold analysis was based on the 2006 model by <hi rend="fc">Q</hi>uiñonez <hi rend="italic">et al</hi>. Simple calculations were used to “align” the Indiana Medicaid data with the published model. <hi rend="fc">Q</hi>uarterly likelihoods that a child would receive treatment for caries were annualized. The probability of a tooth developing a cavitated lesion was multiplied by the probability of using restorative services. Finally, this rate of restorative services given cavitation was multiplied by 1.5 to generate the threshold to attain cost‐savings. Restorative services utilization rates, extrapolated from available <hi rend="fc">I</hi>ndiana <hi rend="fc">M</hi>edicaid claims, were compared with these thresholds.</p>
Results
<p>For children 1‐2 years old, restorative services utilization was 2.6 percent, which was below the 5.8 percent threshold for cost‐savings. However, for children 3‐5 years of age, restorative services utilization was 23.3 percent, exceeding the 14.5 percent threshold that suggests cost‐savings.</p>
Conclusions
<p>Combining a published model with state‐specific data, we were able to quickly and inexpensively demonstrate that restorative service utilization rates for children 36 months and older in Indiana are high enough that fluoride varnish regularly applied by physicians to children starting at 9 months of age could save Medicaid funds over a 3‐year horizon.</p></abstract><textClass><keywords><term xml:id="jphd12026-kwd-0001">oral health</term><term xml:id="jphd12026-kwd-0002">fluorides, topical</term><term xml:id="jphd12026-kwd-0003">fluoride varnish</term><term xml:id="jphd12026-kwd-0004">costs and cost analysis</term><term xml:id="jphd12026-kwd-0005">threshold analysis</term><term xml:id="jphd12026-kwd-0006">cost‐containment</term><term xml:id="jphd12026-kwd-0007"><hi rend="fc">M</hi>edicaid</term></keywords><keywords rend="tocHeading1"><term>Original Articles</term></keywords><keywords rend="articleCategory"><term>Original Article</term></keywords></textClass><langUsage><language ident="en"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/712A07EB12A58DF205DB5A5AC4FEBDE17D524483/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component type="serialArticle" version="2.0" xml:id="jphd12026" xml:lang="en"><header><publicationMeta level="product"><doi origin="wiley">10.1111/(ISSN)1752-7325</doi><issn type="print">0022-4006</issn><issn type="electronic">1752-7325</issn><idGroup><id type="product" value="JPHD"></id></idGroup><titleGroup><title sort="JOURNAL OF PUBLIC HEALTH DENTISTRY" type="main">Journal of Public Health Dentistry</title><title type="short">J Public Health Dent</title></titleGroup></publicationMeta><publicationMeta level="part" position="09104"><doi>10.1111/jphd.2013.73.issue-4</doi><copyright ownership="thirdParty">© 2013 American Association of Public Health Dentistry</copyright><numberingGroup><numbering number="73" type="journalVolume">73</numbering><numbering type="journalIssue">4</numbering></numberingGroup><coverDate startDate="2013-09">Fall 2013</coverDate></publicationMeta><publicationMeta level="unit" status="forIssue" type="article" position="50"><doi>10.1111/jphd.12026</doi><idGroup><id type="unit" value="JPHD12026"></id></idGroup><countGroup><count number="7" type="pageTotal"></count></countGroup><titleGroup><title type="tocHeading1">Original Articles</title><title type="articleCategory">Original Article</title></titleGroup><copyright ownership="thirdParty">© 2013 American Association of Public Health Dentistry</copyright><eventGroup><event agent="bestset" date="2013-07-02" type="xmlCreated"></event><event date="2012-09-26" type="manuscriptReceived"></event><event date="2013-06-16" type="manuscriptAccepted"></event><event type="publishedOnlineEarlyUnpaginated" date="2013-07-26"></event><event type="firstOnline" date="2013-07-26"></event><event type="publishedOnlineFinalForm" date="2013-11-29"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.6.4 mode:FullText" date="2015-10-03"></event></eventGroup><numberingGroup><numbering type="pageFirst">297</numbering><numbering type="pageLast">303</numbering></numberingGroup><correspondenceTo><lineatedText><line><b>Correspondence</b></line><line>Dr. Kristin S. Hendrix, 410 W. 10th Street, Suite HS 1020, Indianapolis, IN 46202‐5140. Tel.: 317‐278‐0552; Fax: 317,278 0456; e‐mail: <email>kshendri@iu.edu</email>. Kristin S. Hendrix, Stephen M. Downs, and Nancy L. Swigonski are with Children's Health Services Research, Indiana University. Stephen M. Downs and Nancy L. Swigonski are with Regenstrief Institute, Inc. Ginger Brophy is with Truven Health Analytics. Caroline Carney Doebbeling is with MDWise, Inc. Nancy L. Swigonski is with Public Health, Indiana University.</line></lineatedText></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file://JPHD.JPHD12026.pdf"></link></linkGroup></publicationMeta><contentMeta><titleGroup><title type="short">Threshold analysis of fluoride varnish reimbursement</title><title type="shortAuthors">K.<fc>S</fc>. <fc>H</fc>endrix <i>et al</i>.</title><title type="main">Threshold analysis of reimbursing physicians for the application of fluoride varnish in young children</title></titleGroup><creators><creator affiliationRef="#jphd12026-aff-0001" corresponding="yes" creatorRole="author" xml:id="jphd12026-cr-0001"><personName><givenNames>Kristin S.</givenNames><familyName>Hendrix</familyName><degrees>PhD</degrees></personName></creator><creator affiliationRef="#jphd12026-aff-0001 #jphd12026-aff-0002" creatorRole="author" xml:id="jphd12026-cr-0002"><personName><givenNames>Stephen M.</givenNames><familyName>Downs</familyName><degrees>MD</degrees></personName></creator><creator affiliationRef="#jphd12026-aff-0003" creatorRole="author" xml:id="jphd12026-cr-0003"><personName><givenNames>Ginger</givenNames><familyName>Brophy</familyName><degrees>MPl</degrees></personName></creator><creator affiliationRef="#jphd12026-aff-0004" creatorRole="author" xml:id="jphd12026-cr-0004"><personName><givenNames>Caroline</givenNames><familyName>Carney Doebbeling</familyName><degrees>MD</degrees></personName></creator><creator affiliationRef="#jphd12026-aff-0001 #jphd12026-aff-0002 #jphd12026-aff-0005" creatorRole="author" xml:id="jphd12026-cr-0005"><personName><givenNames>Nancy L.</givenNames><familyName>Swigonski</familyName><degrees>MD</degrees></personName></creator></creators><affiliationGroup><affiliation countryCode="US" xml:id="jphd12026-aff-0001"><orgDiv>Children's Health Services Research</orgDiv><orgName>Indiana University</orgName><address><city>Indianapolis</city><countryPart>IN</countryPart><country>USA</country></address></affiliation><affiliation countryCode="US" xml:id="jphd12026-aff-0002"><orgName>Regenstrief Institute, Inc.</orgName><address><city>Indianapolis</city><countryPart>IN</countryPart><country>USA</country></address></affiliation><affiliation countryCode="US" xml:id="jphd12026-aff-0003"><orgName>Truven Health Analytics</orgName><address><city>Indianapolis</city><countryPart>IN</countryPart><country>USA</country></address></affiliation><affiliation countryCode="US" xml:id="jphd12026-aff-0004"><orgName>MDWise, Inc.</orgName><address><city>Indianapolis</city><countryPart>IN</countryPart><country>USA</country></address></affiliation><affiliation countryCode="US" xml:id="jphd12026-aff-0005"><orgDiv>Public Health</orgDiv><orgName>Indiana University</orgName><address><city>Indianapolis</city><countryPart>IN</countryPart><country>USA</country></address></affiliation></affiliationGroup><keywordGroup type="author"><keyword xml:id="jphd12026-kwd-0001">oral health</keyword><keyword xml:id="jphd12026-kwd-0002">fluorides, topical</keyword><keyword xml:id="jphd12026-kwd-0003">fluoride varnish</keyword><keyword xml:id="jphd12026-kwd-0004">costs and cost analysis</keyword><keyword xml:id="jphd12026-kwd-0005">threshold analysis</keyword><keyword xml:id="jphd12026-kwd-0006">cost‐containment</keyword><keyword xml:id="jphd12026-kwd-0007"><fc>M</fc>edicaid</keyword></keywordGroup><fundingInfo><fundingAgency>Indiana Medicaid Medical Advisory (MMAC)</fundingAgency><fundingNumber>MD29‐9‐49‐09‐LF‐0203</fundingNumber></fundingInfo><abstractGroup><abstract type="main"><title type="main">Abstract</title><section xml:id="jphd12026-sec-0001"><title type="main">Objective</title><p>Most state Medicaid programs reimburse physicians for providing fluoride varnish, yet the only published studies of cost‐effectiveness do not show cost‐savings. Our objective is to apply state‐specific claims data to an existing published model to quickly and inexpensively estimate the cost‐savings of a policy consideration to better inform decisions – specifically, to assess whether <fc>I</fc>ndiana <fc>M</fc>edicaid children's restorative service rates met the threshold to generate cost‐savings.</p></section><section xml:id="jphd12026-sec-0002"><title type="main">Methods</title><p>Threshold analysis was based on the 2006 model by <fc>Q</fc>uiñonez <i>et al</i>. Simple calculations were used to “align” the Indiana Medicaid data with the published model. <fc>Q</fc>uarterly likelihoods that a child would receive treatment for caries were annualized. The probability of a tooth developing a cavitated lesion was multiplied by the probability of using restorative services. Finally, this rate of restorative services given cavitation was multiplied by 1.5 to generate the threshold to attain cost‐savings. Restorative services utilization rates, extrapolated from available <fc>I</fc>ndiana <fc>M</fc>edicaid claims, were compared with these thresholds.</p></section><section xml:id="jphd12026-sec-0003"><title type="main">Results</title><p>For children 1‐2 years old, restorative services utilization was 2.6 percent, which was below the 5.8 percent threshold for cost‐savings. However, for children 3‐5 years of age, restorative services utilization was 23.3 percent, exceeding the 14.5 percent threshold that suggests cost‐savings.</p></section><section xml:id="jphd12026-sec-0004"><title type="main">Conclusions</title><p>Combining a published model with state‐specific data, we were able to quickly and inexpensively demonstrate that restorative service utilization rates for children 36 months and older in Indiana are high enough that fluoride varnish regularly applied by physicians to children starting at 9 months of age could save Medicaid funds over a 3‐year horizon.</p></section></abstract></abstractGroup></contentMeta> </header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Threshold analysis of reimbursing physicians for the application of fluoride varnish in young children</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Threshold analysis of fluoride varnish reimbursement</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Threshold analysis of reimbursing physicians for the application of fluoride varnish in young children</title></titleInfo><name type="personal"><namePart type="given">Kristin S.</namePart><namePart type="family">Hendrix</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Children's Health Services Research, Indiana University, IN, Indianapolis, USA</affiliation><affiliation>Dr. Kristin S. Hendrix, 410 W. 10th Street, Suite HS 1020, Indianapolis, IN 46202‐5140. Tel.: 317‐278‐0552; Fax: 317,278 0456; e‐mail: . Kristin S. Hendrix, Stephen M. Downs, and Nancy L. Swigonski are with Children's Health Services Research, Indiana University. Stephen M. Downs and Nancy L. Swigonski are with Regenstrief Institute, Inc. Ginger Brophy is with Truven Health Analytics. Caroline Carney Doebbeling is with MDWise, Inc. Nancy L. Swigonski is with Public Health, Indiana University.</affiliation><affiliation>E-mail: kshendri@iu.edu</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Stephen M.</namePart><namePart type="family">Downs</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Children's Health Services Research, Indiana University, Indianapolis, IN, USA</affiliation><affiliation>Regenstrief Institute, Inc., IN, Indianapolis, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ginger</namePart><namePart type="family">Brophy</namePart><namePart type="termsOfAddress">MPl</namePart><affiliation>Truven Health Analytics, IN, Indianapolis, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Caroline</namePart><namePart type="family">Carney Doebbeling</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>MDWise, Inc., IN, Indianapolis, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Nancy L.</namePart><namePart type="family">Swigonski</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Children's Health Services Research, Indiana University, Indianapolis, IN, USA</affiliation><affiliation>Regenstrief Institute, Inc., Indianapolis, IN, USA</affiliation><affiliation>Public Health, Indiana University, IN, Indianapolis, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><dateIssued encoding="w3cdtf">2013-09</dateIssued><dateCreated encoding="w3cdtf">2013-07-02</dateCreated><dateCaptured encoding="w3cdtf">2012-09-26</dateCaptured><dateValid encoding="w3cdtf">2013-06-16</dateValid><copyrightDate encoding="w3cdtf">2013</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><abstract>Most state Medicaid programs reimburse physicians for providing fluoride varnish, yet the only published studies of cost‐effectiveness do not show cost‐savings. Our objective is to apply state‐specific claims data to an existing published model to quickly and inexpensively estimate the cost‐savings of a policy consideration to better inform decisions – specifically, to assess whether Indiana Medicaid children's restorative service rates met the threshold to generate cost‐savings.</abstract><abstract>Threshold analysis was based on the 2006 model by Quiñonez et al. Simple calculations were used to “align” the Indiana Medicaid data with the published model. Quarterly likelihoods that a child would receive treatment for caries were annualized. The probability of a tooth developing a cavitated lesion was multiplied by the probability of using restorative services. Finally, this rate of restorative services given cavitation was multiplied by 1.5 to generate the threshold to attain cost‐savings. Restorative services utilization rates, extrapolated from available Indiana Medicaid claims, were compared with these thresholds.</abstract><abstract>For children 1‐2 years old, restorative services utilization was 2.6 percent, which was below the 5.8 percent threshold for cost‐savings. However, for children 3‐5 years of age, restorative services utilization was 23.3 percent, exceeding the 14.5 percent threshold that suggests cost‐savings.</abstract><abstract>Combining a published model with state‐specific data, we were able to quickly and inexpensively demonstrate that restorative service utilization rates for children 36 months and older in Indiana are high enough that fluoride varnish regularly applied by physicians to children starting at 9 months of age could save Medicaid funds over a 3‐year horizon.</abstract><note type="funding">Indiana Medicaid Medical Advisory (MMAC) - No. MD29‐9‐49‐09‐LF‐0203; </note><subject><genre>keywords</genre><topic>oral health</topic><topic>fluorides, topical</topic><topic>fluoride varnish</topic><topic>costs and cost analysis</topic><topic>threshold analysis</topic><topic>cost‐containment</topic><topic>Medicaid</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Public Health Dentistry</title></titleInfo><titleInfo type="abbreviated"><title>J Public Health Dent</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><subject><genre>article-category</genre><topic>Original Article</topic></subject><identifier type="ISSN">0022-4006</identifier><identifier type="eISSN">1752-7325</identifier><identifier type="DOI">10.1111/(ISSN)1752-7325</identifier><identifier type="PublisherID">JPHD</identifier><part><date>2013</date><detail type="volume"><caption>vol.</caption><number>73</number></detail><detail type="issue"><caption>no.</caption><number>4</number></detail><extent unit="pages"><start>297</start><end>303</end><total>7</total></extent></part></relatedItem><identifier type="istex">712A07EB12A58DF205DB5A5AC4FEBDE17D524483</identifier><identifier type="ark">ark:/67375/WNG-BHH4614N-C</identifier><identifier type="DOI">10.1111/jphd.12026</identifier><identifier type="ArticleID">JPHD12026</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2013 American Association of Public Health Dentistry© 2013 American Association of Public Health Dentistry</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-L0C46X92-X">wiley</recordContentSource></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/document/712A07EB12A58DF205DB5A5AC4FEBDE17D524483/metadata/json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Santé/explor/EdenteV1/Data/Istex/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000414 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Istex/Corpus/biblio.hfd -nk 000414 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Santé
|area= EdenteV1
|flux= Istex
|étape= Corpus
|type= RBID
|clé= ISTEX:712A07EB12A58DF205DB5A5AC4FEBDE17D524483
|texte= Threshold analysis of reimbursing physicians for the application of fluoride varnish in young children
}}
| This area was generated with Dilib version V0.6.33. |  |