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Understanding the Impacts of Dental Benefits for Adults on Oral Healthcare Workforce and Services Delivery at Federally Qualified Health Centers

Award Number: R03DE036009
ORGANIZATION: NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 07/14/2026
PERIOD OF PERFORMANCE END DATE: 07/13/2028

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Understanding the Impacts of Dental Benefits for Adults on Oral Healthcare Workforce and Services Delivery at Federally Qualified Health Centers - Project Summary/Abstract Oral health is a key component of overall health but many low-income individuals in the U.S. have historically experienced poor oral health outcomes. While state Medicaid programs that incorporate comprehensive adult dental benefits have proven effective in improving access, many beneficiaries still struggle to find a dentist willing to serve them, primarily due to less than half of private dentists participating in Medicaid. Consequently, Federally Qualified Health Centers (FQHCs) have increasingly become a primary source of dental care for many low-income populations with and without Medicaid insurance. In 2023, of 30 million individuals receiving care at FQHCs, 6.4 million received oral health services. While various strategies have been explored to potentially mitigate financial and workforce-related challenges faced by FQHCs, it is unknown whether larger visit-driven dental revenue could help optimize FQHC’s dental service capacity, especially for specialized treatments. Given FQHCs rely on Medicaid prospective payment encounters for more than 40 % of their operating revenue, the Affordable Care Act’s Medicaid eligibility expansion paired with extensive dental benefits offers a natural experiment to fill such knowledge gap. Using a multilevel retrospective cohort study of FQHCs with facility-level data from the Uniform Data System (UDS) from 2011-2019, we employ an event-study difference-in-differences design and address the following specific aims: 1) Examine the effects of expanding Medicaid eligibility for extensive dental benefits on oral healthcare workforce composition at FQHCs; 2) investigate the effects on the delivery of dental services at FQHCs including an examination of different types of dental services (e.g., diagnostic, preventive, restorative, and complex dental visits) and 3) evaluate heterogeneity in these effects by local supply of dentists, FQHC's size, rural/urban location, and racial/ethnic distributions of the patient population. Access to the restricted UDS data is provided through a collaboration between the University of Alabama at Birmingham and the HRSA-sponsored George Washington University Health Workforce Institute. The data will be interpreted in partnership with an expert of FQHC service delivery and administration to better understand the real-world implications of findings related to FQHCs’ “revenue-to-workforce” responsiveness and inform the next steps of testing various investment and workforce models to maximize system capacity and cost-efficiency in delivering dental care services to all Americans.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $333,063 )
2026	2026	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH STREET	BIRMINGHAM	AL	35294	JEFFERSON	USA	Oral Diseases and Disorders Research	000	1	7/16/2026	NEW	$333,063
														Subtotal = $333,063

Grand Total All Awards = $333,063

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Understanding the Impacts of Dental Benefits for Adults on Oral Healthcare Workforce and Services Delivery at Federally Qualified Health Centers

Award Number: R03DE036009

ORGANIZATION: NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 07/14/2026

PERIOD OF PERFORMANCE END DATE: 07/13/2028

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