Research Conducted at Harvard University School of Dental Medicine Has Provided New Information about Health and Medicine (Dental Coverage Through Medicaid Managed Care vs Fee-for-Service): Health and Medicine

2026 MAR 11 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Current study results on Health and Medicine have been published. According to news reporting originating from Boston, Massachusetts, by NewsRx correspondents, research stated, “Adult dental coverage under Medicaid varies widely across states and delivery systems. Most adult beneficiaries are now enrolled in managed care, yet little is known about how these benefits are structured and implemented within Medicaid managed care organizations (MCOs).”

Our news editors obtained a quote from the research from the Harvard University School of Dental Medicine, “To examine trends in the generosity, delivery models, and enrollment patterns of adult dental benefits delivered through Medicaid MCOs and assess coverage alignment with Medicaid fee-for-service (FFS) coverage. This cross-sectional analysis included adult Medicaid beneficiaries aged 19 years or older who had state Medicaid MCO or FFS coverage across all 50 states and Washington, DC. This analysis used a novel linked national dataset combining multiple Centers for Medicare & Medicaid Services administrative sources from 2016 to 2022. The analysis was conducted from April 8, 2025, to October 8, 2025. State-level Medicaid MCO or FFS program with adult comprehensive dental coverage, emergency-only dental coverage, or no dental coverage. The generosity of dental benefits; the degree of alignment in benefit generosity between Medicaid MCO and Medicaid FFS programs; and enrollment of adults in dental MCO or FFS programs by benefit (coverage) type. The number of states offering comprehensive adult dental benefits through Medicaid MCOs increased from 33 (64.7%) in 2016 to 36 (70.6%) in 2022. Carve-out models, typically using stand-alone prepaid health plans for dental coverage, increased from 4 states (7.8%) in 2016 to 8 states (15.7%) in 2022. In 2016, 51.0% of states had mismatched benefit levels between MCO and FFS programs compared with 35.3% in 2022. The number of MCO enrollees with comprehensive dental coverage increased from 14.2 million (58.7%) in 2016 to 25.3 million (59.8%) in 2022, reflecting substantial managed care penetration. This study found that although the generosity and scope of MCO dental benefits expanded over time, alignment with FFS programs remained inconsistent.”

According to the news editors, the research concluded: “As new legislation cuts federal funding to states, understanding how dental benefits are designed and delivered is critical to inform future coverage decisions and ensure equitable access.”

For more information on this research see: Dental Coverage Through Medicaid Managed Care vs Fee-for-Service. JAMA Health Forum, 2026;7(2). JAMA Health Forum can be contacted at: Amer Medical Assoc, 330 N Wabash Ave, Ste 39300, Chicago, IL 60611-5885, USA.

The news editors report that additional information may be obtained by contacting Ningsheng Zhao, Dept. of Oral Health Policy and Epidemiology, Harvard University School of Dental Medicine, Harvard University, Boston, Massachusetts. Additional authors for this research include Hawazin W. Elani, Jacob Wallace and Benjamin D. Sommers.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1001/jamahealthforum.2025.6958. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

Publisher contact information for the journal JAMA Health Forum is: Amer Medical Assoc, 330 N Wabash Ave, Ste 39300, Chicago, IL 60611-5885, USA.

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