# Oral health care use characteristics in a limited sample of Medicare Advantage beneficiaries, Medicare Advantage Encounter data 2021

**Authors:** Darien J. Weatherspoon, Susan Hutfless, John F. Moeller, Richard J. Manski

PMC · DOI: 10.1016/j.adaj.2025.03.005 · Journal of the American Dental Association (1939) · 2025-06-12

## TL;DR

This study examines dental care use among a limited sample of Medicare Advantage beneficiaries using 2021 encounter data to understand patterns and factors associated with oral health service utilization.

## Contribution

The study provides insights into dental care use patterns and associated factors in a limited Medicare Advantage beneficiary sample using encounter data.

## Key findings

- 47% of the sample had at least one recorded dental care use event in 2021.
- Age, dual-eligibility, Medicare qualification reason, and plan type were associated with dental care use.
- Dental care use data were available for only a small subset of plans in the MA Encounter data.

## Abstract

In contrast to the limited dental benefits available through traditional Medicare, most Medicare Advantage (MA) plans offer dental care services to eligible beneficiaries. MA Encounter data were made available to better understand the use of health services by MA beneficiaries. The authors’ objectives were to determine the degree to which dental care use data are available in the MA Encounter data source and understand the characteristics associated with dental care use in a sample of MA beneficiaries.

The 2021 Centers for Medicare & Medicaid Services Master Beneficiary Summary File, Plan Benefit Package, and Encounter data sources were analyzed. The primary outcome was receipt of at least 1 dental care service during the year, identified by a CDT 2021: Current Dental Terminology code. Bivariate analyses and a multivariable logistic regression model were used to assess the association between dental care use and sociodemographic factors in a sample of MA beneficiaries.

A total of 23,725 MA beneficiaries in 21 plans met the inclusion criteria. Overall, 47% of beneficiaries in the sample had a CDT 2021: Current Dental Terminology code–recorded dental care use event. Beneficiaries used a range of comprehensive dental care services. Age, dual-eligibility status (ie, eligible for both Medicare and Medicaid), Medicare qualification reason, and plan type were associated with dental care use.

Dental care use data were available for only a small subset of plans within the MA Encounter data source. Select beneficiary characteristics were associated with dental care use in a limited MA beneficiary sample.

There is a need for MA plans to enhance reporting of supplemental dental care use data to better understand whether MA is facilitating use of oral health care for the full beneficiary population.

## Full-text entities

- **Diseases:** oral diseases (MESH:D009059), CDT (MESH:D009057), CMS (MESH:C536089), xerostomia (MESH:D014987), PACE (MESH:D003586), end-stage kidney disease (MESH:D007676), disability (MESH:D009069)
- **Chemicals:** fluoride (MESH:D005459)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

32 references — full list in the complete paper: https://tomesphere.com/paper/PMC12160556/full.md

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Source: https://tomesphere.com/paper/PMC12160556