Study: Medicaid dental programs in seven states could save $550M per year by adopting of Kool Smiles model

January 31, 2016

The Benevis Foundation released a study by Dobson DaVanzo & Associates examining Medicaid dental utilization trends and expenditures in seven states, using publicly available Medicaid dental claims. The study found providers from Kool Smiles - a national dental practice serving pediatric Medicaid patients - performed more conservative, cost-effective care when compared to other Medicaid dental providers in Texas, Indiana, Virginia, Georgia, Mississippi, Louisiana and South Carolina. The analysis supports research indicating that the dental service organization model is narrowing the gap in access to quality dental care for low-income children and families. The study found:

  • Kool Smiles dental providers performed 15% fewer services overall, including 40% fewer extractions and 39% fewer pulpotomies;
  • Kool Smiles patients had an overall average monthly Medicaid expenditure that was 33% lower than non-Kool Smiles patients across all states and years analyzed;
  • If all Medicaid dental providers in those states adopted the same care protocol and utilization rates as Kool Smiles providers, the total savings to state Medicaid programs would be more than $550 million annually; and 
  • The annual Medicaid savings could fund the provision of dental care for up to 1.9 million more Medicaid children who currently do not receive care.