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.