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Comparison of Kool Smiles Utilization and Medicaid Expenditures Across States using Government-Provided Data

February 1, 2016
By Joan DaVanzo, Audrey El-Gamil, Nikolay Manolov, Dorothy Chen, Al Dobson

This multi-state, multi-year analysis from Dobson DaVanzo & Associates uses publicly available Medicaid data to examine how Kool Smiles, a company utilizing DSO, performed.

More than 40 percent of U.S. children ages 2 to 11 experience baby tooth decay, and about 25 percent of children ages 6 to 18 suffer from untreated permanent tooth decay

• Oral diseases affect overall health and disproportionately affect the poor, people of color, and children – those without access to resources to enable optimal oral health

• Only 44 percent of Medicaid children in the U.S. receive dental care, compared to 58.1 percent for those who are covered by commercial insurance, despite a dental benefit being required by all Medicaid and Children’s Health Insurance Program (CHIP) programs

• Dental Support Organizations (DSOs) enable dentists to practice in some of the most disadvantaged communities, thus, bridging the gap in access to dental services between Medicaid and commercially insured individuals

• DSOs are largely responsible for the increase in dental visits among Medicaid populations who previously did not receive dental services

• DSOs provide administrative support to dentists, allowing them to focus on patient care and practice more efficiently

• Benevis Practice Service (Benevis) is a DSO that provides non-clinical support services to Kool Smiles, a national children’s dental provider

• Kool Smiles dentists are led by licensed senior dentists who provide training, professional guidance, clinical protocol, and audits

• The Benevis Foundation commissioned Dobson DaVanzo & Associates, LLC (Dobson | DaVanzo) to conduct an analysis to:

• Examine the utilization and Medicaid expenditures for Kool Smiles providers vs. non-Kool Smiles providers that operate within the same geographic area 

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Health Care