An Early Look at the Effects of the 2022 Dental Loss Ratio Ballot Initiative in Massachusetts. Have Dental Insurers Increased Prices for Dental Services?

OBJECTIVE: To examine whether the November 2022 Massachusetts Dental Loss Ratio ballot initiative was associated with an increase in dental service prices. DATA SOURCES AND ANALYTIC SAMPLE: We used quarterly price data from the Fluent DentaBase commercial claims dental database. Data was aggregated by state and quarter. We extracted data for Massachusetts and five comparison states: Connecticut, Maryland, New Jersey, New York, and Rhode Island from Quarter 1, 2022 through Quarter 2, 2025. STUDY DESIGN: To account for the small number of states in our study, we used a pre-intervention unit-demeaning difference-in-differences estimator. We estimated cross-sectional regressions to estimate the average treatment effect on the treated over the entire post-intervention period after Quarter 4, 2022 and quarter-specific treatment effects. Exact inference was used to ascertain statistical significance of policy effects. PRINCIPAL FINDINGS: Allowed prices for dental procedures increased 5.2% (95% CI: 2.3%-8.0%), and the insurer discount applied to submitted charges declined 2.8 percentage points (95% CI: -5.3 to -0.19 percentage points) relative to the comparison states. CONCLUSIONS: Prior to full implementation of the dental loss ratio requirement in 2025, dental insurers in Massachusetts increased reimbursement to dentists to possibly meet the required dental loss ratio threshold.