It’s hard to miss the fact that our health care system is in the middle of a lot of change. I read about “pay for performance,” “accountable care organizations” and “value-based care” all the time. Oral health is not usually part of the discussion but that won’t be for long. The growing cost of care, the variation in treatments and care outcomes and the significant disparities faced by disadvantaged groups are important issues for dental care delivery too.
So I am very excited by the strong interest and motivation among my peers to find opportunities to focus on quality rather than quantity in America’s oral health care delivery system. I just returned from a meeting in Washington, D.C. with leaders in oral health and health care from across the care delivery spectrum (ADA, ADEA, CDHP, ADHA, CDC, HRSA, IHI, CMS, dental educators, providers, hospitals, health policy experts, insurers and more) where quality improvement and accountability were the central topics. Folks left the meeting ready to take part in this Quality Journey.
The impetus for the meeting was a new report (just released), edited by Paul Glassman DDS, MA, MBA, professor of dental practice and director of the Pacific Center for Special Care at the University of the Pacific Arthur A. Dugoni School of Dentistry. The report, Oral Health Quality Improvement in the Era of Accountability, is a call for a new dialogue on how to improve quality and increase access to affordable dental care.
Until now, the limited evidence of best practice for most dental procedures has led to widespread variation in clinical decisions among dentists; [Read the blog post, To Fill or Not to Fill by my colleague Dr. Doyle Williams to understand the variability in treatment approaches.] And today, there are few incentives to implement quality improvement programs.
But we need to. Dental expenses are now one of the highest out-of-pocket health costs for consumers. And 37 percent of African American children and 41 percent of Hispanic children have untreated tooth decay, compared to 25 percent of white children. The disparity is unacceptable.
Take a close look at the ideas in this report. We need to look at the opportunities to do better.
At the DentaQuest Institute, we’re emphasizing prevention and disease management in our quality improvement initiatives. The good news is that this approach works. When we apply a disease management model to the care of a chronic disease like Early Childhood Caries (ECC), we are seeing longer-term improvements in the patient’s oral health.
The DentaQuest Institute will post the presentations from the meeting in Washington on our website.
This is an exciting time for those of us who are passionate about better oral health for all.