Health News
Dentists should be paid according to the outcomes of their patients and should be monitored more closely given that there is great variability and expense when it comes to dental care, a new report argues.
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Health News
As with health care reform, dentistry should move from volume to value, report urges
Dentists should be paid according to the outcomes of their patients and should be monitored more closely given that there is great variability and expense when it comes to dental care, a new report argues. "I think there is broad consensus that the current oral health system doesn't meet the needs of a significant portion of the population," said Paul Glassman, professor of dental practice at University of the Pacific Arthur A. Dugoni School of Dentistry and lead author of the report "Oral Health Quality Improvement in the Era of Accountability."
The report, funded by the W.K. Kellogg Foundation and the DentaQuest Institute, was released as the U.S. healthcare system is undergoing a transition from the "pay-for-performance" model to "value-based care." The paper argues oral health should likewise move in the same direction and make the transition from "volume to value."
The report found dentistry is the second-highest out-of-pocket health care cost after prescription medicines, and, like health care in general, its cost is increasing, reports Laird Harrison for Medscape News. Another issue is the government just pays for about 6 percent of dental care nationally, the report found, leaving people to pay for care themselves.
While expensive, the care dentists give can be inconsistent, the report found. Though Glassman said dentistry is not lacking in standards, there is limited evidence of the best practice for most dental procedures, the report found.
Another issue, the report contends, is dentists are paid according to what they produce, not by how successful they are in their outcomes. As such, dentists are resistant to change since there are few incentives to implement quality improvement programs. "If the question is 'what's the optimum system for providers,' then many feel the optimum system is what we have now," Glassman said. "If the question is 'what's the optimum system for the public,' then you will come to a different set of assumptions."
To help improve the system, the report recommends a number of proposals, including:
? The increased use of electronic health records
? Development and use of measures for oral health outcomes
? Tying incentives to the oral health of the population being served
? Relying more on allied dental professionals and non-dental professionals
It also suggests relying more heavily on telemedicine, with Glassman envisioning "hygienists and dental assistants going into schools, nursing homes, and other areas with underserved populations to deliver preventive care," Harrison reports. "Dentists, monitoring from afar with access to dental charts stored on the Internet, could gain more patients."
Steven Silverstein, director of the graduate program in dental public health at the University of California San Francisco, said the report was "outstanding" and agreed that the care dentists give can be inconsistent, saying, "If you ask 10 dentists to look at a patient you will get 10 different opinions." Part of the problem, he said, is 98 percent of dentists either practice alone or with one or two partners.
Silverstein did take issue with the fact that the report did not mention the high cost of dental education; didn't take cosmetic dentistry into account; and it did not explain how reform could lower the cost of dental care. (Read more)
- State, Dental Schools Start Pilot Program To Forgive Loans Of Dental Graduates Who Set Up Practice In Appalachian Kentucky
By Al Cross Kentucky Health News ANNVILLE, Ky. ? Two to five new graduates of Kentucky's dental schools will each have up to $150,000 of their tuition debt forgiven if they practice dentistry in Appalachian Kentucky, under a pilot program state and...
- More Dental Patients Using Ers, Showing Lack Of Dental Coverage, Shortage Of Dentists And The Stepchild Status Of Oral Health
More patients are going to hospital emergency rooms for dental care, illustrating how oral health remains the stepchild of the health system despite health-care reform. "An analysis of the most recent federal data by the American Dental Association shows...
- Oral Health Care For The Poor In Kentucky Suffers Under Managed Care As Dentists Leave Medicaid; How About Your County?
Kentucky's serious oral-health problems are getting worse because fewer dentists are participating in the Medicaid program -- a result of "new paperwork issues compounding Medicaid's reputation" for low payments to providers, Laura Ungar reports...
- State Starting Free Training For Dentists In Pediatric Dentistry
One of the many problems with Kentucky's oral health is that not enough dentists are willing to accept children as patients, or lack proficiency in treating children when they are around age 1, the recommended time for a child's first dental visit....
- Woodford County Coalition Formed To Improve Dental Health
The Woodford County Oral Health Coalition has partnered with nine local dentists to give free dental care to 16 elementary students in the Woodford County public school system. On Jan. 27, coalition members and Woodford County Judge-Executive John Coyle...