Oral health care use characteristics in a limited sample of Medicare Advantage beneficiaries, Medicare Advantage Encounter data 2021.

backgroundIn contrast to the limited dental benefits available through traditional Medicare, most Medicare Advantage (MA) plans offer dental care services to eligible beneficiaries. MA Encounter data were made available to better understand the use of health services by MA beneficiaries. The authors' objectives were to determine the degree to which dental care use data are available in the MA Encounter data source and understand the characteristics associated with dental care use in a sample of MA beneficiaries.

methodsThe 2021 Centers for Medicare & Medicaid Services Master Beneficiary Summary File, Plan Benefit Package, and Encounter data sources were analyzed. The primary outcome was receipt of at least 1 dental care service during the year, identified by a CDT 2021: Current Dental Terminology code. Bivariate analyses and a multivariable logistic regression model were used to assess the association between dental care use and sociodemographic factors in a sample of MA beneficiaries.

resultsA total of 23,725 MA beneficiaries in 21 plans met the inclusion criteria. Overall, 47% of beneficiaries in the sample had a CDT 2021: Current Dental Terminology code-recorded dental care use event. Beneficiaries used a range of comprehensive dental care services. Age, dual-eligibility status (ie, eligible for both Medicare and Medicaid), Medicare qualification reason, and plan type were associated with dental care use.

conclusionsDental care use data were available for only a small subset of plans within the MA Encounter data source. Select beneficiary characteristics were associated with dental care use in a limited MA beneficiary sample. PRACTICAL IMPLICATIONS: There is a need for MA plans to enhance reporting of supplemental dental care use data to better understand whether MA is facilitating use of oral health care for the full beneficiary population.