A new study from a University of Iowa researcher examines whether a special waiver from a public insurance program incentivizes people to visit the dentist.

Healthy behavior incentives (HBI) are an initiative from Medicaid, a joint federal and state program that helps cover medical costs for eligible people. HBIs provide financial incentives to encourage healthy behaviors. One targeted healthy behavior is dental health, to address the fact that only half of low-income Medicaid beneficiaries visit the dentist each year. HBI waivers were designed to improve upon that percentage, but the results have been inconclusive. 

Jason Semprini, a postdoctoral researcher in the College of Public Health, compared the number of dental visits in three states that offered HBI waivers — Indiana, Wisconsin, and Michigan — with 43 other states that had not offered the incentive. 

In Indiana, there was no statistically significant change in dental visits after HBI waivers were made available. In Wisconsin, fewer people visited the dentist despite the waiver incentive. Semprini found Michigan was the only state to record a statistically significant increase in dental visits after HBI waivers were offered. The differences among the three states are likely due to varying HBI incentive structures and how those incentives were offered, Semprini found. 

“Policymakers must design the HBI waiver that is explicit to the outcome they want and make sure they follow through if they want it to succeed,” Semprini recommends.

Semprini is the sole author of the study, “Incentivizing dental services in healthy behaviour Medicaid waivers,” published online in the journal Community Dentistry and Oral Epidemiology.

The National Institute of Dental and Craniofacial Research, a branch of the National Institutes of Health, funded the work.