Improving dental care access for Medicaid-enrolled adults through a dental clinic co-located within a rural health center: A mixed-methods study

Abstract: Purpose. Rural Medicaid enrollees face barriers to dental care. We evaluated outcomes of a dental clinic co-located within a health center in Jefferson County, a rural Health Professional Shortage Area (HPSA) in Washington state. Methods. In this mixed-methods study, we conducted 33 interviews and inductively coded the data. Using Medicaid data for adult enrollees, linear regression estimated dental use changes after clinic establishment by location of care (Jefferson County vs. elsewhere). Findings. We identified three domains. The clinic 1) provided affordable, accessible care meeting community needs; 2) faced challenges including extensive waitlists and staff shortages; 3) could address challenges by expanding clinic facilities and services offered. Adult Medicaid enrollees' dental care use increased 8.3% in Jefferson County (95% CI 4.1, 12.5) and declined 3.5% elsewhere (95% CI –6.3, –0.65) after the clinic was established. Discussion. A co-located dental clinic addressed barriers to care for rural Medicaid enrollees, yet challenges persist.