As we move through 2020, there's convincing research showing that many Americans - including dentists, patients, employers, and health care providers - agree that the oral health system is failing. In fact, countries like Australia, Norway, and Germany have significantly better health outcomes than the United States, and yet we still spend more on health care in this country.
As for oral health, it's staggering to know that over 70 million Americans lack dental coverage. Equally concerning is the fact that, while all states are required to provide dental benefits for children covered by Medicaid, fewer than half provide extensive benefits for adults. Considering that Americans are concerned about their oral health more than heart, digestive or mental health, it's obvious that time is of the essence to fix our broken system.
Research and data cultivated by interviews with stakeholders in the oral health industry - dentists, physicians, and patients - can help us bolster solutions to quality and access to care. We can embrace a prevention-first approach, as opposed to the same old, ineffective, and inefficient reactionary approach - one that produces high costs, creates fear and erects barriers to accessing care.
Research has demonstrated that over 90 percent of all systemic diseases have oral manifestations. This means we must put the whole body at the center of the care experience. Medical-dental integration is a collaborative solution that extends care beyond the dentist chair to include physicians, nurses, dental hygienists, and dental therapists.
The value-based care delivery model rewards providers for quality health outcomes rather than the quantity of services delivered. The objectives of value-based care align with the Institute of Healthcare Improvement's triple aim of better quality and experience of care for individuals and improved population health at lower per-person cost.
There is growing consensus among dentists and physicians that value-based care can reduce costs and improve patient outcomes. Employers are taking notice of this approach too, with more than half surveyed expressing their organizations would be interested in implementing a value-based Ccare benefit design for dental coverage.
In the current fee-for-service model, dental providers are paid based on the number and types of procedures they perform, which are often invasive. More procedures equal more revenue. With a value-based care payment system, providers are incentivized for keeping patients healthy by incorporating prevention-first, evidence-based, minimally-invasive care. It starts with administrative and clinical leadership who are willing to shift the focus of care from volume to value. Care is provided in non-traditional settings or methods such as a doctor's office or through the use of teledentistry, the entire care team is engaged and patient outcomes are tracked and monitored.
While the U.S. clearly lags behind other countries who have higher health system performance, and lower costs, states like Maryland and Washington have recently made big strides in providing better access to care through expansion of dental services to places such as community health centers, and dental referrals through medical practitioners. And there's proof that more effective financial and reimbursement models such as value-based care are needed to drive necessary and purposeful change that produces better health outcomes per dollar spent.
Myechia Minter-Jordan, MD is the President and CEO of the DentaQuest Partnership for Oral Health Advancement and Catalyst Institute. She joined DentaQuest in 2019 after 12 years as CEO and CMO at the Roxbury, Mass.-based Dimock Center.