Understanding value in oral health: the oral health value‐based care symposium

Abstract

Objective: There are both opportunities and challenges with the implementation of oral health value-based care (OHVBC). To tackle concerns and advance conversation, a symposium was convened with subject matter experts to develop a gap analysis and capture insights into professional readiness for value-based care design. Methods: The symposium was convened as a private event for 46 participants over the course of one and a half days in December 2019. Thematic analyses utilized the OHVBC Readiness Framework (DentaQuest Partnership, 2019) to further codify conversations as part of the gap-analysis process. Poll Everywhere, a text messaging application that allows participants to answer questions in real time, was also employed to solicit responses. Results: Attendees of the symposium felt that OHVBC would have a large portion of market share within the next 10 years. A qualitative assessment of multiple table discussions determined that the participants developed more consensus around themes for the current state and the future-desired state than the actionplanning needed to close the gap between the two. This may relate to individual ideology, and the siloed environment is still prevalent in the oral health realm. In a postsymposium survey, respondent attendees did not perceive that COVID-19 would delay or negatively impact the adoption of OHVBC and may result in accelerating its utilization. Conclusion: The oral health community is experiencing multiple drivers to adopt more OHVBC within business and care models. However, there is still a lack of uniformity on how to execute this delivery model.

Value-Based Healthcare From the Perspective of the Healthcare Professional: A Systematic Literature Review

“…Analysis revealed 10 specific behaviors that professionals pursued in VBHC, next to acting upon their professional standards ( 68 ). These interconnected and mutually reinforcing behaviors, as visualized in Figure 4 , are to (1) focus on what matters to patients and adopt other VBHC mindsets ( 24 , 31 – 33 , 47 , 50 , 52 , 53 , 61 , 62 ), (2) measure outcomes ( 14 , 24 , 31 – 35 , 44 , 56 , 68 ), (3) learn and improve care ( 14 , 24 , 31 – 34 , 47 , 53 , 62 , 66 , 68 – 70 ), (4) organize care around the full cycle of disease ( 24 , 32 , 44 , 45 , 54 , 60 , 61 , 64 , 66 , 70 – 73 ), (5) participate in population health and prevention ( 24 , 62 , 66 , 70 , 72 ), (6) discuss value in the clinical encounter ( 31 , 47 , 50 , 55 , 56 , 58 , 63 , 64 , 74 , 75 ), (7) involve patient representatives ( 24 , 31 – 33 , 50 ), (8) take accountability for patients and resources ( …”

“…Organizational support and legitimacy VBHC resource ( 24) "Even if it was impossible to make use of all the patient representatives' opinions and experiences, participants were proud of their cooperation with the representatives as this contributed to the legitimacy of their implementation work" (24) Environment resource (24,33,48,50,69) "Over time, participants came to understand the importance of the hospital director's unequivocal standpoint that VBHC was to be used as a management tool. This standpoint gave legitimacy to decisions within the teams" (33) Environment demand (24,32,33,35,55,72,76) "Participants felt they had been thrown into the deep end when it came to implementation work" (33) Pride VBHC resource ( 24) "[…] participants were proud of their cooperation with the representatives as this contributed to the legitimacy of their implementation work" (24) complexity with new tasks in VBHC as a result of task expansion (60). The second study suggested information overload due to working with care pathways (73).…”

Provider Teledentistry Use Gains Traction During COVID-19

“…The results also revealed that dental providers who use telehealth are 34% more familiar with alternative payment models (APMs) and are 45% more likely to have an increased interest in learning about APMs than those who don't use telehealth. With the expected rise of valuebased care and APMs in dentistry 4 , telehealth can be used as a tool to extend care in ways that enhance the financial sustainability of dental practices. Telehealth can reduce the cost of care through efficient and widespread delivery of care and oral health education, while also enhancing the capacity of practices to provide care for additional patients or existing patients with more complex needs.…”

Effect of Mobile- Based Educational Program through Bluetooth and WhatsApp. Application on the Oral Health Values, Dental Literacy, and Oral Self-Efficacy among Older Adults.

“…Oral health values have been closely related to treatment-seeking behaviors, as attending dental appointments, and engaging in preventive oral care because values provide older people with standards for behavior to reach optimum oral haleness based on the perceived magnitude of a certain oral health comportment. Oral health values are wellacquainted as the extent to which one views dental status as important or meaningful, by dedication to improve or maintain one's teeth, gingiva, and other aspects of orofacial functioning" [17] . Regrettably, older people head to drive supplementary attention to treating their systematic comorbidities rather than oral disorders, despite the possibility that, at such life juncture, the oral health troubles are aroused and triggered [18] .…”