Medicaid_Dental_Caseload_Cost_by_DentalRptRgn_SFY2018_SFY2027_v.xlsx

XLSX spreadsheet 46 KB Posted

Attached to
Medicaid and Children’s Health Insurance Program Dental Services
Solicitation number
HHS0017108
Issued by
Texas

About this file

Written by GovTribe AI ·

This is a Medicaid dental caseload and cost analysis file prepared by the Texas Health and Human Services Commission (HHSC) CFO Forecasting division. The document provides comprehensive enrollment data and cost projections for Medicaid dental services across Texas from September 2017 through August 2027, organized by dental reporting regions including Bexar, Dallas, El Paso, Harris, Hidalgo, Jefferson, Lubbock, Nueces, Tarrant, Travis, and three MRSA (Managed Rural Service Areas). The data tracks total state enrollment and regional distributions with monthly granularity through November 2024, followed by forecasted projections through August 2027. The file does not contain specific response dates, bidder meetings, site visits, or contract award information; instead, it serves as a planning and forecasting document for budget analysis and resource allocation.

The cost analysis demonstrates Medicaid dental expenditures ranging from $86.4 million to $120 million annually across the forecast period, with per-member-per-month (PMPM) costs declining from $34.49 in FY 2018 to $30.00 in FY 2024, then increasing to $32.67 projected for FY 2027. Historical enrollment peaked in May 2023 at approximately 4.27 million members before declining significantly through late 2023 and early 2024, stabilizing around 2.9 to 3.0 million members from late 2024 onward. The regional cost breakdowns are calculated based on overall dental PMPM applied to regional caseloads, with Harris County consistently representing the largest enrollment and cost concentration. This forecasting data was finalized through November 2024 and issued by HHSC CFO Forecasting in August 2025, providing baseline information for dental services planning and procurement decisions.

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Other files

File Type Posted
Exhibit G, Medicaid and CHIP Dental Services Statement Of Work (SOW).pdf PDF
Exhibit Q, Evaluation Tool and Scoring Example.pdf PDF
Exhibit C, Deliverables-Liquidated Damages Matrix.pdf PDF
Exhibit S, TDI Certificate of Authority Table.pdf PDF
Exhibit P, Consensus Scoring Rubric.pdf PDF
Exhibit J, Certification Regarding Lobbying.pdf PDF
Exhibit A, Dental Contract Terms and Conditions.pdf PDF
Exhibit H, HHS Solicitation Affirmations v. 2.10.pdf PDF
Exhibit E, Access Standards Map.pdf PDF
VPAT2.5Rev_WCAG_February2025.docx DOCX document
D00010_837D_LTC_Companion_Guide.pdf PDF
Exhibit I, Federal Assurances Non-Construction Programs.pdf PDF
Exhibit K, Exceptions.docx DOCX document
CHIP_T_Dental_Caseload_Cost_by_SDA_SFY2018_SFY2027_v.xlsx XLSX spreadsheet
Exhibit F, Dental Reporting Regions Map.pdf PDF
ESBD_561159_1791405468508_HHS0017108_Dental_Services.pdf PDF
Exhibit M, Subcontracting Plan.pdf PDF
Exhibit B, Uniform Managed Care Manual (UMCM).pdf PDF
Exhibit N, Breach Disclosure History.pdf PDF
Exhibit L, Assumptions.docx DOCX document
CHIP_T_SDA_County_Zip_201709_202411_v.xlsx XLSX spreadsheet
Exhibit O, Medicaid and Children's Health Insurance Program (CHIP) Dental Services Scoring Guides.pdf PDF
Exhibit R, Procurement Library.pdf PDF
Medicaid_Dental_DentalReportingRegion_County_Zip_201709_202411_v.xlsx XLSX spreadsheet
Exhibit D, Texas Medicaid Provider Procedures Manual.pdf PDF
TX Medicaid and CHIP Enrolled Dental Providers SFY2025YTD_final.xlsb XLSB spreadsheet
D00022_837D_Acute_Care_Companion_Guide.pdf PDF
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Medicaid_Dental_DRR_Caseload Medicaid Dental Caseload by Dental Reporting Region*

MonthTotal EnrollmentBexarDallasEl PasoHarrisHidalgoJeffersonLubbockNuecesTarrantTravisMRSA CentralMRSA NortheastMRSA West
Sep-172,937,144250,656393,007119,438709,689354,44878,07973,96087,640264,914143,602136,119171,487154,105
Oct-172,943,694250,733391,827119,131718,144353,69078,98573,71288,005264,177143,686136,157171,666153,781
Nov-172,974,571252,313394,370119,705733,407354,93480,50874,09889,196265,993145,298137,353172,868154,528
Dec-172,976,990252,258393,895119,567736,375354,81280,62374,07389,153265,706145,768137,484172,776154,500
Jan-182,944,452250,609391,109118,873721,682353,05878,94373,54587,574263,672144,701136,344171,483152,859
Feb-182,931,308250,228390,173118,339713,513353,08978,43973,51786,911262,712144,927136,167171,107152,186
Mar-182,918,340250,188390,496118,141702,885352,32877,57973,46186,202262,879144,656136,337171,033152,155
Apr-182,902,092248,718388,873117,633697,553350,62877,10373,10985,523261,837143,993135,728170,106151,288
May-182,901,837249,264388,952117,784696,296350,37777,06273,20785,378262,230144,478135,859170,017150,933
Jun-182,892,540249,399387,895117,578692,229349,33976,81173,15285,213261,554144,004135,607169,454150,305
Jul-182,879,944248,712385,667116,980690,208347,26976,79472,76485,165260,013143,187135,246168,588149,351
Aug-182,877,622248,756384,856116,645691,953345,91377,26772,41885,364259,445143,159135,255167,946148,645
Sep-182,870,548248,223383,433116,324690,883344,57977,43072,21485,450258,674142,446135,236167,626148,030
Oct-182,866,016247,843382,383115,913691,800343,43377,65672,08785,350257,987142,113135,159167,199147,093
Nov-182,877,675248,533383,683115,839697,306343,77178,26972,20285,529258,925142,206135,706167,888147,818
Dec-182,877,012248,705383,177115,515697,688343,55078,51472,23685,586258,970142,225135,569167,791147,486
Jan-192,855,064246,896379,762114,678692,375341,48378,04871,59485,167256,623141,051134,558166,666146,163
Feb-192,846,418246,160378,656114,368689,148341,04277,77771,48184,891256,024140,591134,574166,085145,621
Mar-192,838,049245,795377,875114,051685,181340,13577,53971,30884,587255,680140,535134,685165,834144,844
Apr-192,799,601242,694373,683112,356674,536335,93076,51570,44083,166252,076138,883133,247163,864142,211
May-192,791,351242,114373,330112,147671,584334,81676,21670,09882,863251,861138,582133,053163,331141,356
Jun-192,783,060241,961372,951111,840667,719333,67675,92570,14982,539251,471138,295132,784162,883140,867
Jul-192,773,062241,617371,182111,395665,518332,33175,65669,89782,305250,687137,641132,606162,194140,033
Aug-192,793,401243,499373,668111,625671,627333,85076,26970,45382,891252,765138,793133,952163,042140,967
Sep-192,794,602243,858373,560111,474673,156333,33376,47870,36383,086252,532138,913134,062162,970140,817
Oct-192,797,306244,112373,277111,233674,526333,12276,63770,51383,382253,121139,212134,332163,051140,788
Nov-192,798,808244,372373,098110,904676,254332,93676,72470,47883,459252,922139,159134,356163,043141,103
Dec-192,795,978243,989371,725110,601676,734332,47376,81670,48583,354252,607139,128134,318162,779140,969
Jan-202,784,482242,964369,498109,940674,651331,68476,62370,23883,266251,065138,260133,772162,188140,333
Feb-202,766,219241,538366,111109,116670,167330,28576,35169,89282,908249,108137,323132,816161,092139,512
Mar-202,773,188242,457366,326109,161671,142331,73776,64770,13083,222249,770137,299133,321161,657140,319
Apr-202,871,819250,611381,032112,361695,932340,57479,42972,52885,760260,067142,765137,800167,255145,705
May-202,960,648257,989393,815115,172719,021348,16581,89474,70787,908269,650147,764141,660172,193150,710
Jun-203,038,497264,130404,211117,561740,234355,46184,12376,64390,105277,848152,041144,834176,141155,165
Jul-203,115,343270,393414,206119,843760,602363,00186,25478,35492,106285,887156,339147,919180,285160,154
Aug-203,163,737274,408420,775121,413772,927367,38087,59979,53593,261290,999159,083150,009183,074163,274
Sep-203,217,425278,707428,135123,034786,739371,93089,37980,74494,450296,693162,133152,274186,505166,702
Oct-203,270,214282,837435,370124,866800,138376,66590,77482,12095,799302,275165,114154,696189,641169,919
Nov-203,313,831286,492441,347126,207810,709380,29192,20283,30596,763307,042167,689156,912192,288172,584
Dec-203,370,408291,080449,514127,984825,006384,89994,03284,64098,229312,749170,885159,600195,710176,080
Jan-213,435,761296,482458,615130,105842,578389,95995,80186,28199,727320,160174,507162,436199,426179,684
Feb-213,482,963300,531465,095131,558854,594393,77297,37387,416100,834325,439177,339164,502202,159182,351
Mar-213,518,032303,609470,139132,545863,631396,60298,46488,202101,664329,475179,291166,095204,175184,140
Apr-213,551,374305,882475,530133,688873,183398,94899,42688,825102,210333,391181,247167,332205,898185,814
May-213,587,316308,682480,453134,880882,430401,809100,57989,664103,008337,569183,270169,009208,024187,939
Jun-213,618,126311,072485,314135,587890,570403,984101,45390,306103,722341,030185,210170,447209,785189,646
Jul-213,656,310314,162490,669136,779900,392406,843102,57391,167104,615345,594187,444172,251212,028191,793
Aug-213,685,272316,545494,805137,673907,843409,213103,41391,788105,279348,915189,210173,593213,557193,438
Sep-213,720,173319,390500,042138,805916,725411,646104,36292,625106,080352,992191,312175,234215,740195,220
Oct-213,749,185321,885504,134139,783924,475413,913105,22293,291106,601356,327192,905176,496217,368196,785
Nov-213,786,747325,158509,578141,028934,316416,776106,23494,147107,363360,622195,038178,276219,405198,806
Dec-213,823,512328,477514,948142,227943,687419,576107,36594,943107,993364,910197,187180,041221,492200,666
Jan-223,850,226330,566518,970143,094950,577421,737108,12095,568108,530367,989198,615181,275223,041202,144
Feb-223,884,739333,660523,775144,150959,583424,325109,14196,401109,253371,819200,788182,884224,918204,042
Mar-223,912,164336,014527,903144,938966,946426,349109,98497,069109,762374,887202,303184,104226,442205,463
Apr-223,946,423339,031532,774145,947976,090428,623110,91397,931110,449378,974204,489185,469228,399207,334
May-223,969,620341,048536,280146,670982,370430,025111,75698,433110,834381,749205,623186,519229,722208,591
Jun-223,999,034343,495540,268147,622989,865431,907113,00399,139111,396385,267207,214187,976231,516210,366
Jul-224,023,171345,569543,466148,418995,922433,667113,92499,795111,930388,355208,499189,044232,891211,691
Aug-224,041,395347,207546,065148,9551,000,506434,851114,697100,184112,248390,436209,546189,815234,054212,831
Sep-224,069,262349,857550,070149,7861,006,998436,952115,838100,883112,904393,387211,134191,146235,718214,589
Oct-224,091,564351,751553,166150,4201,012,841438,566116,654101,319113,345395,919212,370192,251237,102215,860
Nov-224,159,730357,798561,340153,1131,027,804445,346119,126103,336115,291403,055215,686195,697241,686220,452
Dec-224,180,382359,804564,343153,7081,033,039446,681119,906103,821115,653405,594216,516196,833242,881221,603
Jan-234,196,897361,177566,046154,1511,037,440448,060120,598104,215115,933407,519217,501197,554244,069222,634
Feb-234,215,769362,742569,113154,6351,042,105449,118121,480104,705116,193409,736218,784198,480244,950223,728
Mar-234,234,886364,205571,968155,1521,046,707450,354122,221105,160116,510411,885219,970199,503246,082225,169
Apr-234,257,435366,188575,221155,8921,052,386451,793123,055105,551117,013414,690221,398200,550247,207226,491
May-234,269,126367,236577,050156,1291,055,779452,076123,471105,651117,050416,418222,307200,996247,762227,201
Jun-233,985,748343,649536,264145,318987,184425,831116,35498,659109,898385,709206,489187,395231,581211,417
Jul-233,941,749340,156529,747143,448976,529421,117115,48197,649108,556381,091204,258185,336229,121209,260
Aug-233,837,412331,970514,969139,651950,351411,765112,86695,035106,000369,909197,557180,342223,266203,731
Sep-233,674,886317,824492,217133,915911,474398,173108,73090,640101,935351,710188,092172,603213,733193,840
Oct-233,512,708303,871470,320127,720873,384382,985104,51985,88197,495334,354179,443164,619204,392183,725
Nov-233,334,353288,977444,267121,609827,648366,33099,63981,38793,293315,164169,606157,163194,817174,453
Dec-233,150,075273,555418,749114,694783,556349,67694,61676,54388,488294,862159,273148,164184,365163,534
Jan-242,970,145259,527390,495108,675739,377333,69390,00272,40284,493275,308148,193139,947174,373153,660
Feb-242,967,282259,492389,946108,467738,956333,42890,00972,35984,644274,826147,546139,997174,193153,419
Mar-242,975,969260,255391,153108,683741,671334,08790,25572,60484,964275,174148,131140,492174,683153,817
Apr-242,987,533261,358392,576108,795744,888335,00190,68673,10685,116276,185148,912141,181175,286154,443
May-242,973,560260,769390,322108,318740,628333,50490,48572,73684,733274,996148,254140,513174,519153,783
Jun-242,939,453258,223385,159106,969731,626330,46889,62972,01883,885271,255146,670139,076172,434152,041
Jul-242,935,250257,867384,845106,549730,975329,71489,64071,86783,688270,810146,635138,775172,104151,781
Aug-242,949,092259,133386,654106,622735,326330,38090,31372,15084,003272,506147,159139,406172,728152,712
Sep-242,930,517257,751384,398105,732731,314328,36190,11271,58883,500270,569145,857138,471171,680151,184
Oct-242,889,142253,809378,500104,014722,997325,03189,29370,51382,476265,285143,160136,529169,022148,513
Nov-242,903,772255,275381,057103,959726,640325,36189,92770,78182,682267,084144,567137,191169,814149,434
Dec-242,909,511251,764389,159109,152715,968325,51782,88672,38083,087273,397148,007137,514169,192151,487
Jan-252,901,187251,043388,045108,840713,920324,58682,64972,17382,850272,614147,583137,120168,708151,054
Feb-252,901,444251,066388,080108,850713,983324,61582,65672,18082,857272,639147,596137,133168,723151,067
Mar-252,922,153252,857390,850109,627719,079326,93283,24672,69583,448274,585148,650138,111169,928152,146
Apr-252,930,013253,538391,901109,922721,014327,81183,47072,89083,673275,323149,049138,483170,385152,555
May-252,941,799254,557393,477110,364723,914329,13083,80673,18484,009276,431149,649139,040171,070153,168
Jun-252,931,843253,696392,146109,990721,464328,01683,52272,93683,725275,495149,143138,569170,491152,650
Jul-252,929,900253,528391,886109,917720,986327,79883,46772,88883,670275,312149,044138,477170,378152,549
Aug-252,931,842253,696392,145109,990721,464328,01683,52272,93683,725275,495149,143138,569170,491152,650
Sep-252,932,171253,724392,190110,003721,545328,05383,53272,94483,734275,526149,159138,585170,510152,667
Oct-252,935,587254,020392,646110,131722,385328,43583,62973,02983,832275,847149,333138,746170,709152,845
Nov-252,939,262254,338393,138110,269723,290328,84683,73473,12183,937276,192149,520138,920170,922153,036
Dec-252,942,589254,626393,583110,393724,108329,21883,82973,20384,032276,505149,689139,077171,116153,210
Jan-262,944,341254,777393,817110,459724,539329,41483,87973,24784,082276,669149,778139,160171,218153,301
Feb-262,947,527255,053394,243110,579725,323329,77183,96973,32684,173276,969149,940139,311171,403153,467
Mar-262,952,442255,478394,901110,763726,533330,32084,10973,44884,313277,431150,190139,543171,689153,723
Apr-262,955,510255,744395,311110,878727,288330,66484,19773,52584,401277,719150,347139,688171,867153,882
May-262,960,268256,156395,948111,057728,459331,19684,33273,64384,537278,166150,589139,913172,144154,130
Jun-262,963,308256,419396,354111,171729,207331,53684,41973,71984,624278,452150,743140,056172,321154,288
Jul-262,968,261256,847397,017111,357730,426332,09084,56073,84284,765278,917150,995140,291172,609154,546
Aug-262,972,556257,219397,591111,518731,482332,57184,68273,94984,888279,321151,214140,494172,859154,770
Sep-262,974,129257,355397,802111,577731,870332,74784,72773,98884,933279,469151,294140,568172,950154,852
Oct-262,977,149257,616398,205111,690732,613333,08584,81374,06385,019279,752151,447140,711173,126155,009
Nov-262,979,194257,793398,479111,767733,116333,31384,87174,11485,077279,944151,551140,807173,245155,115
Dec-262,981,582258,000398,798111,856733,704333,58184,93974,17385,145280,169151,673140,920173,383155,240
Jan-272,983,860258,197399,103111,942734,264333,83585,00474,23085,210280,383151,789141,028173,516155,358
Feb-272,987,210258,487399,551112,067735,088334,21085,10074,31385,306280,698151,959141,186173,711155,533
Mar-272,992,369258,933400,241112,261736,358334,78785,24774,44285,453281,182152,222141,430174,011155,801
Apr-272,996,510259,292400,795112,416737,377335,25185,36574,54585,572281,572152,432141,626174,251156,017
May-273,001,260259,703401,430112,595738,546335,78285,50074,66385,707282,018152,674141,850174,528156,264
Jun-273,004,493259,982401,863112,716739,342336,14485,59274,74385,800282,322152,838142,003174,716156,433
Jul-273,009,692260,432402,558112,911740,621336,72685,74074,87385,948282,810153,103142,249175,018156,703
Aug-273,013,458260,758403,062113,052741,548337,14785,84874,96686,056283,164153,294142,427175,237156,899
Fiscal Year Summary: Average Members Per Month
Total EnrollmentBexarDallasEl PasoHarrisHidalgoJeffersonLubbockNuecesTarrantTravisMRSA CentralMRSA NortheastMRSA West
FY 20182,923,378250,153390,093118,318708,661351,65778,18373,41886,777262,928144,288136,138170,711152,053
FY 20192,830,938245,337377,815113,838682,947339,05077,15171,18084,194255,145140,280134,261165,367144,374
FY 20202,888,386251,735383,970113,232700,446341,67979,63172,82285,985262,131143,941138,267167,977146,571
FY 20213,475,586299,673464,582131,242853,151392,91097,12287,038100,525325,028176,945164,096201,600181,674
FY 20223,892,199334,292524,850144,303961,755424,450109,56096,627109,370372,861201,127183,094225,416204,495
FY 20234,119,997354,711555,775150,9501,019,097439,805118,921102,165113,696399,576213,664193,840239,285218,511
FY 20243,114,192271,738411,392113,418774,959346,45394,04476,14188,061290,596156,493146,828182,302161,767
FY 20252,918,594253,548388,470108,363721,062326,76484,88072,26283,308272,852147,621137,934169,990151,538
FY 20262,951,152255,367394,728110,715726,215330,17684,07373,41684,276277,309150,125139,482171,614153,655
FY 20272,991,742258,879400,157112,237736,204334,71785,22974,42685,436281,124152,190141,400173,974155,769
*Data is final through Nov2024. Forecast begins Dec2024.
HHSC CFO Forecasting, August 2025

Medicaid_Dental_DntlRptRgn_Cost

Estimated Medicaid Dental Costs by Dental Reporting Region*
Total Fiscal Year Costs
State Fiscal YearTotal CostBexarDallasEl PasoHarrisHidalgoJeffersonLubbockNuecesTarrantTravisMRSA CentralMRSA NortheastDental Cost PMPM**
FY 2018$ 95,624,896$ 8,627,122$ 13,441,306$ 4,109,400$ 24,419,591$ 12,230,740$ 2,692,803$ 2,529,477$ 3,001,095$ 9,034,417$ 4,958,576$ 4,688,815$ 5,891,55434.49
FY 2019$ 89,710,432$ 8,192,258$ 12,595,882$ 3,830,085$ 22,758,932$ 11,412,207$ 2,569,184$ 2,373,768$ 2,817,119$ 8,491,070$ 4,663,409$ 4,480,562$ 5,525,95533.38
FY 2020$ 90,349,661$ 8,299,357$ 12,628,225$ 3,757,699$ 23,040,861$ 11,346,502$ 2,617,905$ 2,391,171$ 2,838,916$ 8,613,172$ 4,721,408$ 4,554,555$ 5,539,89032.94
FY 2021$ 104,193,765$ 9,482,489$ 14,685,698$ 4,164,075$ 26,979,465$ 12,474,008$ 3,070,002$ 2,745,489$ 3,180,636$ 10,270,796$ 5,581,653$ 5,186,289$ 6,373,16631.63
FY 2022$ 114,844,409$ 10,415,090$ 16,346,769$ 4,496,629$ 29,941,324$ 13,233,000$ 3,415,137$ 3,004,393$ 3,406,526$ 11,608,695$ 6,253,795$ 5,703,776$ 7,019,27531.14
FY 2023$ 120,005,995$ 10,913,100$ 17,090,700$ 4,649,461$ 31,327,020$ 13,552,292$ 3,662,582$ 3,136,075$ 3,502,369$ 12,281,598$ 6,553,611$ 5,965,048$ 7,372,14030.76
FY 2024$ 88,596,089$ 8,154,744$ 12,309,117$ 3,426,274$ 23,230,997$ 10,484,966$ 2,827,336$ 2,279,524$ 2,653,684$ 8,684,686$ 4,658,569$ 4,406,505$ 5,479,68930.00
FY 2025$ 86,404,991$ 7,916,738$ 12,120,661$ 3,388,926$ 22,517,774$ 10,222,564$ 2,651,824$ 2,254,210$ 2,603,311$ 8,512,102$ 4,601,148$ 4,306,832$ 5,308,90131.22
FY 2026$ 89,155,971$ 8,138,518$ 12,579,956$ 3,528,467$ 23,144,421$ 10,522,683$ 2,679,385$ 2,339,772$ 2,685,882$ 8,837,828$ 4,784,465$ 4,445,276$ 5,469,31831.87
FY 2027$ 92,643,313$ 8,456,857$ 13,072,021$ 3,666,483$ 24,049,717$ 10,934,278$ 2,784,189$ 2,431,292$ 2,790,940$ 9,183,520$ 4,971,610$ 4,619,153$ 5,683,25132.67
*Cost by SDA are estimated based on overall Dental PMPM and caseload by SDA, as a result casemix between Dental Reporting Region may vary based on actual data.
HHSC CFO Forecasting, August 2025

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