(PR135) Retrospective Analysis of the Impact of MassHealth Medicaid Program Coverage for Endodontic Treatment on Dental Services from 2019 to 2022

Objective: Ten years before 2021, Massachusetts reduced funding for MassHealth dental benefits to address budget shortfalls, leaving many residents without essential dental care. In January 2021, the legislature expended dental benefits, including coverage for molar endodontic treatment. This expansion eliminated tooth extraction as the only covered treatment option for MassHealth patients, significantly broadening access to restorative care. This study aimed to evaluate the impact of this policy change on the frequency of nonsurgical root canal therapy (NS-RCT) provided by Cambridge Health Alliance (CHA). Methods - A retrospective review of electronic health records (EHR) was conducted on endodontic services provided at CHA from July 2019 to June 2022, comparing periods before (Pre-2021: July 2019 to December 2020) and after (Post-2021: January 2021 to June 2022) the MassHealth benefit expansion. NS-RCTs for anterior, premolar, and molar teeth were analyzed for Medicaid, Health Safety Net, and Commonwealth Care Alliance patients. Statistical significance was assessed using chi-squared tests (P < 0.05). Results - The overall NS-RCT volume increased by 230% post-2021, rising from 70 procedures pre-2021 to 233 post-2021. For MassHealth patients, procedures rose by 241% (from 63 to 215), while non-MassHealth patients showed minimal change. Significant increases were observed for anterior, premolar, and especially molar RCTs, as compared to pre-2021 period. Conclusion - The expanded MassHealth dental benefits in 2021 substantially increased access to essential endodontic care for low-income Massachusetts residents, enhancing options for tooth preservation and supporting systemic health for those near the poverty level.