Evidence map›Paper›PMID 39434700›Full record

ArticlePediatrics2024

Affordable Care Act's Preventive Services Coverage Mandate and Receipt of Fluoride Varnish.

Ashley M Kranz, Yuji Mizushima, Andrew W Dick, Kimberley H Geissler, Tadeja Gracner

Abstract read
In one paragraph

Article in Pediatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Ashley M KranzRAND Corporation, Arlington, Virginia.
Yuji MizushimaRAND Corporation, Santa Monica, California.
Andrew W DickRAND Corporation, Boston, Massachusetts.
Kimberley H GeisslerDepartment of Healthcare Delivery and Population Sciences, UMass Chan Medical School-Baystate, Springfield, Massachusetts.
Tadeja GracnerRAND Corporation, Santa Monica, California.

Funding

Promoting children's oral health: Identifying provider-, practice-, and community-level characteristics associated with delivery of fluoride varnish in medical officesR01DE028530 · NIDCR · RAND CORPORATION · PI KRANZ, ASHLEY · 2020 to 2023
$2.1M
NIDCR NIH HHS R01 DE028530
6 · The paper itself

Abstract

BACKGROUND AND

objectivesThe Affordable Care Act required private insurers to cover a set of recommended preventive services without cost-sharing. This included coverage of fluoride varnish (FV) applications without cost-sharing for children aged 1 through 5 during medical visits, an evidence-based treatment that prevents tooth decay. We examined if this coverage mandate was associated with more young children receiving FV.

methodsUsing the Massachusetts All-Payer Claims Database (2014-2018), we examined the likelihood that a privately insured child received FV during a medical visit in a month. We used a difference-in-differences approach, comparing those included in the coverage mandate (aged 1-5) to those excluded from the mandate (aged 6-9), before and after the mandate was enacted (January 2015). We repeated analyses in children with Medicaid because this mandate may have had spillover effects for this population.

resultsAmong children aged 1 through 5 years with private insurance, 1-year postmandate the probability of FV receipt in a month increased 0.16 percentage points more relative to December 2014 (premandate) compared with the change among children aged 6 to 9 years (P < .001; 95% confidence interval = 0.1-0.22). When examining spillover to children with Medicaid, the mandate was not associated with a significant increase in the probability of monthly FV receipt 1-year postmandate.

conclusionsThis Affordable Care Act mandate requiring coverage of FV without cost-sharing was associated with higher rates of young children receiving FV in medical settings, with the largest result observed among children with private insurance.

Indexed as

Fluorides, TopicalInsurance CoverageMedicaidPatient Protection and Affordable Care ActChildChild, PreschoolCost SharingDental CariesFemaleHumansInfantInsurance, HealthMaleMassachusettsPreventive Health ServicesUnited StatesFluorides, Topical

Identifiers

PMID39434700
PMCPMC11524042

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.