Changes in Healthcare coming to Dentistry

The University of Iowa Public Policy Center is establishing the definition of a ‘patient-centered dental home’ through cooperation with the Dental Quality Alliance. Thanks to the input of 55 participants, the survey identified numerous characteristics that could have been included and now is calling for comment on the following definition:

The patient-centered dental home is a model of care that is accessible, comprehensive, continuous, coordinated, patient- and family-centered, and focused on quality and safety.

The reason for this new definition is that dentistry continues to follow medicine – and as health care has been transformed to emphasize “coordinated care that incentivizes value over volume” the patient-centered medical home concept has taken hold. This approach on the medical side connects primary care to primary mental health care and specialty care. This same concept is coming to dentistry. So far, the concept of patient- centered dental home has focused on children via access to care. As this concept is being developed, some medical groups have provided dental preventive care services only – but a dental home needs to include preventive care and treatment for all ages.

What does this mean to dentists & dental office managers?

We read often of the oral and systemic health connection – gum disease linked to low birthweight in babies or heart problems, the need to premedicate for deep cleanings after knee surgery, coordination of care for children’s hospital visits between the pediatric dentist and ENT. Without even touching the hot buttons of obesity or drug-abuse, we can see opportunities where dental care and medical care cross-over.

Thinking of the terms included in this new definition:

• Accessible
• Comprehensive
• Continuous
• Coordinated
• Patient & family-centered
• Focused on quality & safety

The next step for these organizations is to dig deeper into each of these characteristics – What does it mean to be accessible? Comprehensive? You can start thinking about your own practice now, what do these terms mean to you? Just thinking about accessibility – it could mean geographically, for example, is your office near to a bus stop? It could mean what types of insurance or Medicaid do you accept? What hours are you open? How do you handle emergencies? What about after-hours care?

Once these characteristics are defined, then (and this is my favorite part) these organizations will begin the challenge of turning these words into measurable components. Now, how do you measure accessibility? I wonder if we will have several characteristics for each term – and perhaps a scale is developed for each one – and then maybe an average is created from them? And, once these measures exist – that suggests that patients will have access to this information.

Measured Quality of Care for Dentistry

Last in the list, but especially interesting is the focus on quality and safety. If a patient-centered dental home is focused on quality and safety, then how will that practice measure their quality?

In dental practices now, the dental office manager is responsible for running reports and bridging the gap between clinical care and dental measurement. For now, this translates into selecting the proper dental codes, charging the correct fees and contacting patients for recare/follow up. As group practices evolve and office managers expand their expertise – they also will run reports to understand their patient population – age, gender, insurance/Medicaid/3rd party payer, etc. As dental coding advances – already there are codes to track caries risk – high, medium and low – these managers also will have the opportunity to track the quality of care.

The Role of Dental Office Managers

This challenges the normal dental office manager to expand her expertise from managing day-to-day activities of the practice into understanding the value of tracking and measurement in order to demonstrate these characteristics of a patient-centered dental home. This takes a new appreciation for running reports and tracking, rather than just getting tasks done. Take recare – most dental software programs make it easy to pull up a list of patients due for recare so that the dental office manager can easily call the patient, enter a digital note of their message and then move on down the list until the schedule is full. Although this meets the basic need of filling the schedule, it doesn’t at all address the value of tracking and measurement.

Dental office managers who learn to run reports and track the performance of their practices for existing systems, will be well prepared when our field transforms into dentists being paid for value rather than volume. Right now, we can’t even imagine what that might look like in private practice dentistry, but as we watch the progress of the patient-centered dental home concept, it is exciting to think about the difference we will make in the lives of our patients & families.

If you’re interested in using tracking and measurement in your practice, you may be interested in evaluating some of the reports in my Shop – each one tackles a topic from the perspective of running reports so you can measure your practice performance. I include instructions to run specific reports and provide guidance to track performance so you can determine the performance of individual team members as well. With reliable measures, you also can use this approach to reward staff through bonus programs because you can easily see who has accomplished what!

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One of the biggest challenges to managing a dental practice is managing dental insurance. With dental insurance handled, then dental marketing for new patients becomes a primary focus. In today’s day of online reviews, handling patient complaints well is essential. As your practice grows, hiring dental staff becomes more important. With 18+ years of dental practice management experience, I’m open to your questions to help you run a successful dental office.