Putting Teeth in Healthcare Reform

I had the opportunity to attend the Massachusetts Dental Society's New England Oral Health Summit with our clients, the DentaQuest Foundation & the DentaQuest Institute. Attended by hundreds of dentists across New England, the Summit focused on the coming changes to oral health as a result of health care reform and significant cultural shifts in the way health care is delivered. Presentations ranged from an overview of the Affordable Care Act to a discussion about data analytics in dentistry. Among the many questions about changes in the profession, what struck me most were the concerns about the transition from volume-based care to value-based care. In the medical world, this transition began long ago and the ACA is only speeding things up. However, the dental profession is just beginning the transition and without fully understanding what it means, it can be overwhelming. So what is value-based care? Value based care is about focusing on costs, quality and, most importantly, outcomes. The goal is to reduce cost strains and reliance on the health care system by keeping patients healthier. Sounds great, right? The challenge is that under the current system (referred to as fee-for-service), medical professionals are paid each time they provide care to a patient, so if a patient is cared for in a way to prevent further illness, it reduces the need for additional treatment, and doctors and dentists make less money. Healthcare professionals go into the medical field to help patients and the goal is always, first and foremost, to keep patients healthy. But they also need to make a living and run a business so dentists have every reason to feel uneasy about a transition in payment models that could affect their livelihood. Data analytics is king in the new health care delivery model because the focus on outcomes, rather than easily countable treatments, requires measurement. Organizations are developing models to measure preventive treatments and ensure that patients are receiving the high quality care they deserve – and that doctors and dentists are being paid for it. For example, when patients leave the hospital and then are readmitted within 30 days for the same illness, hospitals will now be penalized because for not keeping the patient well. The ultimate goal is to encourage hospitals to keep the patient healthy and out of the hospital. Under value-based care, a number of models have emerged that are believed to be financially viable while also providing better outcomes for patients. We are seeing healthcare organizations merge into larger coordinated care systems like accountable care organizations and patient-centered medical homes. Physicians are moving away from private practice and are trending towards employment in a larger system. Global payments are no longer a buzzword or a theory. They are actually happening. But in dental, this trend is just starting. And it is moving fast. Dentists don't have the time to sit idly by. Instead, they have a unique opportunity to learn about health care reform and make their voices heard by actively participating in the transition. Change is coming and as one of the panelists said at the Summit "if you aren't at the table, you may be on the menu." By Alicia Bandy, Senior Account Executive, Solomon McCown & Company

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