How do you implement value‐based care methodologies in dentistry with existing dental organizational paradigms?

Abstract

The U.S. healthcare sector is a paradox – achieving comparatively poor population health outcomes despite outspending the world – and the current paradigm is a dichotomy – pursuing value definition consisting of quality, outcome, and cost, but failing to act in aligned and informed manner. In 2018, U.S. dental spending was $136 billion, accounting for 3.7 percent of total healthcare spending, a relatively nominal amount when considering oral diseases are among the most prevalent and have serious health and economic burdens, greatly reducing quality of life for those affected. Consistent and growing evidence shows that primary care‐oriented systems achieve better health outcomes, more health equity, and lower costs; however, to date, there is little means to structuralize the role of oral health and quantify the value provided. To understand the reasons behind the abstract nature of value‐based care requires an in‐depth understanding of the drivers impeding the transition to a value based oral health system of care. One large clinically integrated network will provide detail of their experience.

Pre‐doctoral dental faculty perceptions toward value‐based care: An exploratory study

“…Though limited in quantity, rich examples of VBC in dentistry exist in the literature. [18][19][20] One study concluded that Accountable Care organizations (ACOs) are well-positioned to improve access to dental care 18 and Sinnott et al 19 found ACOs do this through several key value-based components: reduction of wasteful/unnecessary services, integration with primary care, comprehensive and integrated health information technology, quality measurement framework, and measurement and improvement of the patient and provider experience. Another study found that dental ACOs that align value-based payment with innovative care delivery models, such as prioritization of prevention, reduced utilization of general anesthesia, and hospitalization for treating dental caries in young children.…”

“…This is partly due to the traditional silo of dentistry from medicine in care delivery and payment (i.e., Medicaid coverage). Though limited in quantity, rich examples of VBC in dentistry exist in the literature 18–20 . One study concluded that Accountable Care organizations (ACOs) are well‐positioned to improve access to dental care 18 and Sinnott et al 19 .…”

“…Though limited in quantity, rich examples of VBC in dentistry exist in the literature 18–20 . One study concluded that Accountable Care organizations (ACOs) are well‐positioned to improve access to dental care 18 and Sinnott et al 19 . found ACOs do this through several key value‐based components: reduction of wasteful/unnecessary services, integration with primary care, comprehensive and integrated health information technology, quality measurement framework, and measurement and improvement of the patient and provider experience.…”