At DentaQuest, we talk with people every day who are both in need of dental care and concerned about the cost of their care. We process claims for a long list of important services provided to children and adults.
While necessary, these covered services are delivered in response to an already present dental disease. Fillings and extractions address the impact of disease but do not address or eliminate its cause — or, said another way, restorative care is more costly and preventive care is more valuable. In a value-based system, quality and outcomes should improve while costs remain the same or fall because the healthier a person is, the less they require expensive services.
The transition to value-based care isn’t as easy as flipping a switch, but a recent DentaQuest survey reveals that many providers see the prevention-focused model as the future of dentistry. Similarly, the vast majority of providers saw medical-dental integration — an approach to care that integrates and coordinates dental medicine into primary care and behavioral health to support individual and population health — as the future of oral health.
“Historically, dentists have largely focused their skills and treatments on diseases and conditions of the teeth,” said Steven Barefoot, DDS, Clinical Manager of Value-Based Payments at DentaQuest. “As we’ve learned more about the importance of oral health to overall health, we’ve seen our approach to dentistry change to one of looking at whole patients and not just their teeth.”
Of the 254 respondents to the survey, which gathered responses from November 2020 to January 2021, two-thirds agreed with the statement: “Value-based care (the provision of accessible, high-quality care that is cost effective while fairly compensating providers) is the future of oral health.” Thirty-one percent “strongly agreed” and 36% “somewhat agreed.”
“Value-based care is the future of dentistry,” says Barefoot. “It’s clear to dentists that there are not enough resources or time to restore all the teeth that are diseased.”
Still, the concepts of value-based care and value-based payments are new for many providers, as evidenced by a recent DentaQuest Partnership for Oral Health Advancement report. Among other findings, the report found that half of (51%) of responding providers have never heard of alternative payment models (APMs) in dentistry, while 35% had only heard of APMs or knew a little about them.
“These results,” the report authors noted, “show the need for further education about APMs and the VBC model among providers as well as growth of its evidence-base in dentistry.”
Awareness of and interest in medical-dental integration was more widespread, according to the DentaQuest survey. Of the 254 survey respondents, 85% “strongly agreed” or “somewhat agreed” with the statement: “Medical-dental integration (the integration of preventive dental care into primary care settings and medical screenings into oral health settings) is an effective way to improve overall health.” Also known as interprofessional practice, or IPP, medical-dental integration has demonstrated positive patient outcomes and reductions in total cost of care. It’s a model of care that holds the patient at the center and allows providers to come up with comprehensive care plans for the whole patient.
Value-based care and medical-dental integration go hand in hand. We continue to move into an era where payers and providers are shifting from a focus on volume of services to the value of those services. It’s becoming clear that taking this holistic, whole-body, prevention-first approach to oral care and health care will have greater financial benefit to providers and, more importantly, afford better access and improved health outcomes for patients.
“The way we will extend oral health services to more people will be by shifting our efforts to prevention,” says Barefoot. “The alternative payment models in VBC will facilitate that shift by paying for oral health outcomes instead of paying for individual services.”