The North Carolina Medicaid Program: Participation and perceptions among practicing orthodontists

Introduction Limited provider participation in the Medicaid program is a barrier to access to orthodontic care for Medicaid-eligible patients. The goals of this study were to determine the participation level of North Carolina (NC) orthodontists in the Medicaid program, to examine NC orthodontists' perceptions of the Medicaid program and its beneficiaries, and to determine whether there are differences between practitioners who do and do not accept Medicaid patients. Methods Questionnaires were mailed to all active orthodontists (n = 203) as reported in the NC State Dental Board of Licensing Section of the NC Health Professions Data System. Respondents were categorized as current Medicaid providers, past Medicaid providers, or orthodontists who have never accepted Medicaid. Results Forty of 166 respondents were current Medicaid providers, 33 were past providers, and 93 never accepted Medicaid patients. All 3 groups thought that low fee reimbursement is a major problem. Those who have never participated in the Medicaid program were more likely to perceive each barrier as a major problem. Past Medicaid providers saw broken appointments and tardiness to appointments as greater problems than current providers. Conclusions Perceptions of Medicaid patients and lack of knowledge appear to be major barriers to provider participation.