ADA pilot program offers blueprint for increasing dentist participation within Medicaid, launches new multistate partnership 

Report highlights successful state-based strategies for expanding access to care 

A new ADA report demonstrates that collaboration among state dental associations, Medicaid agencies, managed care organizations, oral health coalitions and other stakeholders can help increase dentist participation in Medicaid and expand access to oral health care for beneficiaries. 

The report, Increasing Medicaid Participation in Dentistry: A Blueprint from a Six-State Pilot Program, summarizes the results of a two-year initiative led by the ADA Council on Advocacy and Access for Prevention. Beginning in 2023, the pilot brought together stakeholders in Maryland, Nebraska, Ohio, Pennsylvania, Rhode Island and South Dakota to identify and implement strategies to improve Medicaid participation among dentists and increase utilization of dental services by Medicaid beneficiaries. 

The states were selected because they had recently expanded Medicaid dental benefits, increased reimbursement rates or implemented other policy changes aimed at improving access to care. Through monthly state coalition meetings and quarterly cross-state learning collaboratives, participants shared data, discussed challenges and adapted successful strategies from their peers. 

The pilot produced encouraging results, according to the report. Four of the six participating states increased dentist participation in Medicaid and expanded utilization of dental services among beneficiaries. The report found that reimbursement increases should be paired with provider outreach and education, while successful coalitions also offered enrollment assistance, streamlined administrative processes and maintained strong stakeholder collaboration. 

“Multistakeholder coalitions assembled to increase dentist participation in Medicaid are most effective when all key stakeholders involved in assuring access to care under a state’s Medicaid dental benefit are included. Coalitions are least effective when major stakeholders, such as state government or managed care organizations, are not present in carrying out these efforts,” according to the report.  

Here are some of the report’s highlights: 

• Maryland increased the number of dentists participating as adult Medicaid providers and saw growth in meaningful Medicaid providers following the state's expansion of comprehensive adult dental benefits. 

• Nebraska exceeded its goal for newly enrolled Medicaid dentists, increased paid dental claims and improved several key dental quality measures. 

• Pennsylvania increased the number of meaningful Medicaid providers, or those seeing more than 100 patients during the state’s fiscal year. 

• Rhode Island increased Medicaid provider participation, particularly by increasing volunteerism of dentists within federally qualified health centers, and saw gains in meaningful providers, or those seeing more than 100 patients per year, along with Medicaid beneficiary utilization. 

• South Dakota increased dentist participation, meaningful provider engagement and Medicaid beneficiary utilization while increasing the number of preventive services delivered for both children and adults. 

• The report also underscored the importance of reliable data. State-based coalitions with consistent access to Medicaid participation and utilization data were able to identify trends, target interventions and measure progress more effectively. In contrast, states that struggled to obtain data faced barriers to evaluating outcomes and refining strategies. 

Overall, the pilot demonstrated that policy changes were most effective when paired with implementation strategies on the ground. 

“Reimbursement increases should be paired with provider outreach and education to help combat outdated information or long-held beliefs about participating in the program,” according to the report.  

As a follow-up, a new initiative, the “Dental Access Partnership Across States” program will operate on a two-year cycle to help states collaborate with intrastate partners and increase Medicaid participation among dentists. Like the pilot program, participating states will work closely with intrastate partners to identify barriers, implement solutions and exchange best practices with peers across the country. Montana, Virginia and Iowa are participating in the 2026-2027 project cycle. 

“The dental access pilot is the Tripartite at its best: the ADA facilitating action in partnership with state associations, helping us learn from each other and make a meaningful impact on the health of our communities,” said Ryan Dunn, CEO of the Virginia Dental Association. “We have already seen an incredible spirit of collaboration with the Dental Access Partnership in Virginia and are excited to work together to support dentists in increasing access to essential oral health care for Medicaid beneficiaries.” 

To read the report, please visit ada.org/medicaidblueprint.  

To learn strategies to help equip your practice in treating Medicaid beneficiaries , please visit ada.org/medicaidfinancialtoolkit.