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Practice Management

150 - Medicaid Reimbursement and Economic Sustainability in Alabama Pediatric Dental Practice

Friday, May 22, 2026
2:40 PM - 2:55 PM PST
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    Presenting Author(s)

  • Amber Were, DDS (she/her/hers)

    Chief Resident 2025–2026 | Pediatric Dentistry
    University of Alabama - Birmingham
    University of Alabama
    Birmingham, Alabama, United States

    • Co-Author(s)

  • Yu-Yin Lin, DDS, MS

    Assistant Professor | Director, Pre-Doctoral Program in Pediatric Dentistry
    University of Alabama - Birmingham
    Birmingham, Alabama, United States

  • SM

    Stephen C. Mitchell, DMD

    Professor
    University of Alabama - Birmingham
    Birmingham, Alabama, United States

    • Research Mentor(s)

  • Yu-Yin Lin, DDS, MS

    Assistant Professor | Director, Pre-Doctoral Program in Pediatric Dentistry
    University of Alabama - Birmingham
    Birmingham, Alabama, United States

    • Program Director(s)

  • JJ

    Janice G. Jackson, DMD

    Professor, Chair & Program Director
    University of Alabama at Birmingham
    Birmingham, Alabama, United States

Abstract:

Objective: To evaluate economic alignment in Alabama pediatric dental practice by examining Medicaid fee schedules, workforce salaries, and practice expenses considering inflation.

Methods: Descriptive analysis was performed in three domains: 1. Salary trajectories for providers (ADA national data for pediatric dentists), dental assistants, and dental hygienists (Bureau of Labor State-specific) were evaluated by comparing 2024 wages with past years using nominal and CPI-adjusted growth. 2. Pediatric dental practice expenses (ADA national data for specialty) were analyzed similarly using trajectory-based comparisons. 3. Medicaid fee schedules between 2005 and 2025 were analyzed after deflation.

Results: From 2005 to 2025, Alabama Medicaid reimbursement exhibited limited nominal growth with extended periods of stagnation. This chronological structure contrasts with the continuous changes in workforce compensation and practice expenses. After adjusted for inflation, the mean growth was: -33.34% (Diagnostic), -32.22% (Preventive), -26.58% (Restorative), and -37.83% (Pulp/Extraction). Overall, there was a negative 29.96% growth. Two services showed growth were SSC (1.03%) and Pulpotomy (1.58%). Salary analysis revealed provider income rose 22.3% nominally since 2020 but only 0.9% in real terms; real growth since 2015 remained negative (-26.1%). Dental assistants demonstrated robust growth (42.3% since 2005), while hygienists experienced flat or negative growth (-3.3% since 2005). Practice expenses more than doubled nominally since 2000, yet inflation-adjusted comparisons showed minimal actual growth.

Conclusion: When evaluated within a unified inflation-adjusted framework, Medicaid fee schedules appear increasingly misaligned with workforce compensation and practice expenses trajectories, highlighting the value of inflation-adjusted, cross-domain evaluation for contextualizing reimbursement policy and pediatric dental practice sustainability.

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