What is value-based care?
Value-based care (VBC) aims to improve health outcomes while lowering costs, compensating oral health teams for providing high-quality and cost-effective care. This includes coordinating care, involving a broader health care team, utilizing data to monitor clinical outcomes, and addressing social determinants of health. VBC models, which are slowly taking shape in dentistry, are tailored to give providers the necessary resources and flexibility to offer optimal care for their patients.
Today, oral health often remains siloed from the rest of the health care system despite evidence and research linking disease and oral-gut transmission. More specifically, oral health problems have bi-directional relationships with many systemic health problems, including high blood pressure, difficulty managing diabetes, risk of developing Alzheimer’s disease, and pregnancy complications.1 VBC aims to change that reality by better connecting oral health and overall health care and systems.
At the recent inaugural Oral Health Prevention Summit held in Boston, MA, the momentum for VBC was palpable.
What does VBC look like in oral health?
Traditionally, dentistry follows a surgical model of care, where treatment is provided when the disease is already present. This model often results in high costs, invasive procedures, and, eventually, tooth loss that has negative impacts on an individual’s overall health and quality of life.
VBC offers a better, healthier alternative, promoting care and payment models that compensate providers for effectively diagnosing, preventing, and managing oral diseases. This, in turn, empowers patients to improve their health, better manage chronic conditions, and lead healthier lives.
What does VBC look like in practice?
- Patients receive person-centered, risk-based care, following different care pathways that correspond to their needs and ensure an appropriate distribution of resources.
- Clinical workflows and tools are designed to improve the patient and provider experience. For example, providers can see patients virtually via teledentistry, saving the patient time and removing potential transportation barriers.
- Data is collected and analyzed to track oral health trends in the patient population being served—and then used for continuous quality improvement.
- Better communication and collaboration occurs between dentists and dental hygienists. Additionally, collaboration across the care continuum, through AI and cloud-based technologies, can improve patient outcomes.
- Patients see more personalized education and engagement, equipping individuals with knowledge and options around proper oral hygiene, dietary changes, and risk factors for oral disease. This empowers patients to take charge of their oral health.
- Minimally invasive care and products help promote remineralization or gains in periodontal attachment, which is particularly valuable in improving systemic health and impacting cost. These proactive processes promote patient wellness through management of chronic disease.
A focus on preventative care
Dental hygienists are well-positioned to lead the shift to VBC, as they provide critical preventive care and establish trusting relationships with the patient. They are in the ideal position to evaluate individual needs, offering customized education and co-designed treatment plans that align with risk factors and oral health goals. Dental hygienists can significantly aid in data collection by documenting comprehensive patient information, which helps track oral health trends and pinpoint areas for improvement within the practice. As the connection between oral health and overall health gains recognition, dental hygienists can also play a role in coordinating care with other health care providers to address systemic health issues.
These roles and tasks are critical to success in organizations that provide VBC, where teamwork and accountability are part of the culture. For example, in certain VBC models, providers might receive compensation tied to the overall health outcomes of their patients, which promotes a collaborative, proactive approach to care. In other words, in these environments, everyone has an important role to play in improving patient care.
The tools to implement VBC are readily available, and dental hygienists are already making strides in this domain. As the dental profession continues to embrace the shift to prevention and value, they will have more opportunities to shine—and emerge as the MVPs of VBC.
Learn more about value-based care and oral health.
References
- CareQuest Institute for Oral Health. Impacts Beyond the Mouth. Boston, MA; June 2020. DOI: 10.35565/CQI.2020.4002 Copyright © 2021 CareQuest Institute for Oral Health
About the author
Danielle Apostolon, BS, is the Business Management Program Manager at CareQuest Institute for Oral Health. She can be reached at Dapostolon@carequest.org.