# Field Experiment to Assess the Impact of Medicaid on Disparities in Dental Care Utilization

> **NIH NIH R01** · HARVARD MEDICAL SCHOOL · 2024 · $805,545

## Abstract

PROJECT SUMMARY/ABSTRACT
An estimated 9.8 million adults have gained oral health insurance since the implementation of the Affordable
Care Act (ACA). However, utilization of dental services among disadvantaged groups remains low, resulting in
the stubborn persistence of oral health disparities. These findings suggest that there are persistent barriers to
oral health care beyond just coverage alone. According to the Andersen model of healthcare utilization, oral
healthcare utilization is driven by enabling factors (such as insurance access) as well as predisposing factors
(such as oral health literacy). Hence, it is critical to identify the bottlenecks in boosting the uptake of oral
healthcare services, thereby improving the oral health status of minority and low-income Americans. Our overall
objective is to assess whether the availability of dental providers poses a barrier to accessing dental care among
low-income and minority adults. We propose to conduct a field experiment to simulate the experiences of patients
with Medicaid coverage in obtaining dental appointments. Our design takes into account state variations in
Medicaid policies and neighborhood characteristics, thus enabling us to examine the extent to which underlying
structural factors contribute to disparities in access to dental care. Our specific aims are: 1) To examine the
geospatial distribution of dental providers according to neighborhood characteristics; 2) To identify the
association between Medicaid insurance status and availability of dental appointments; and 3) To assess the
cross-level interaction between structural barriers (state Medicaid dental policy and neighborhood
characteristics) and availability of dental appointments among Medicaid beneficiaries. Findings from this study,
using a robust experimental approach and primary data collection, will provide direct and objective measures of
access to dental care to guide states in implementing effective policies to reduce disparities in oral health.

## Key facts

- **NIH application ID:** 10828441
- **Project number:** 5R01MD017093-03
- **Recipient organization:** HARVARD MEDICAL SCHOOL
- **Principal Investigator:** Hawazin W Elani
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $805,545
- **Award type:** 5
- **Project period:** 2022-09-01 → 2027-10-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10828441

## Citation

> US National Institutes of Health, RePORTER application 10828441, Field Experiment to Assess the Impact of Medicaid on Disparities in Dental Care Utilization (5R01MD017093-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10828441. Licensed CC0.

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