Four Common Questions (and Answers) about Value-Based Care

One thing is clear about the dental industry’s transition to value-based care: There are a lot of questions: What is value-based care? Are providers familiar with alternative payment models? What are the benefits of value-based care?

During CareQuest Institute for Oral Health's recent Value-Based Care Office Hour — a bonus session after the webinar on the topic last month — a panel of experts fielded several questions about the how and why of transitioning dentistry to value-based care. The panel included Randal Christensen, Chief Clinical Information Officer, Chiricahua Community Health Centers, Inc.; Brianna Hillier, DMD, Director of Dental Services, Chiricahua Community Health Centers, Inc.; Lisa Simon, MD, DMD, Fellow in Oral Health and Medicine Integration, Harvard School of Dental Medicine; Bob Russell, DDS, MPH, MPA, CPM, FACD, FICD, Consultant, CareQuest Institute for Oral Health; Rebekah Mathews, Director of Value-Based Care, CareQuest Institute for Oral Health; and Danielle Apostolon, Training Specialist, Value-Based Care, CareQuest Institute for Oral Health. The questions from participants ranged from payment and care transformation to data and measurement models.

Here, we share four memorable questions as a quick recap for participants who joined and anyone who wants to learn more about the topic:

How can we get dentists to embrace the value-based care methodology?

Incentives that motivate, changes in dental curriculum, continuing education opportunities in VBC, and closer integration of EHR and protocols with medical care. The shift to value-based care is also coming from external pressures to engage in the development and evaluation of quality metrics and play a role in developing the model. It is important dental has a voice in value-based care design, therefore any opportunities to participate as an early adopter through testing care and payment models that optimize patient health outcomes are important since the future of payment and care delivery will change. 

What would you say motivates providers to embrace value-based care, especially since most view value-based care as generating less revenue?

Value-based care payment models are not one-size-fits-all and can provide opportunities to earn incentives based upon achieving certain quality metrics. Rather than being paid per procedure, providers are reimbursed for the total care provided, which goes beyond treatment to a person-centered approach. Value-based care emphasizes providers and patients seeking minimally invasive and prevention-focused care that is not typically reimbursed under a fee-for-service model.

Dental providers are already spending time interviewing and educating patients, providing preventive care, and tailoring recall intervals to patient needs. Yet in the current system, remuneration is limited to specifically defined services and benefit structures. 

What positive outcomes of value-based care weren’t anticipated by early adopters?

In states that have adopted value-based care, models in primary care are reporting an improvement in no-show rates and chronic disease management and a reduction in costs. Value-based care models also include collaboration with a broader team and acknowledgement of important clinical work previously unremunerated in the fee-for-service system such as inter-visit care and coordination with other providers. Also, it is important to note increased staff rapport and interdisciplinary communication. 

How can the industry shift to a mindset of prevention instead of restoration?

Re-educating the dental profession to see risk-based diagnosis, early intervention, and minimally invasive care as the primary paradigm for dental intervention is the primary pathway. Primary care models like the patient-centered medical home and behavioral health integration demonstrate myriad options for empowering providers to deliver team-based preventive care rather than reactive restorative care. 

For example, quality metrics can incentivize primary care teams to screen, refer, or provide preventive care and enable other members of the care team to provide continuous care. Successful value-based care innovations within medicine do not punish providers and systems for providing invasive care when needed; instead, they allow the development of systems that make it easier and more rewarding to provide the care providers already like: spending time on education, targeting at-risk patients with more intensive preventive services, and building meaningful relationships with patients and colleagues. 

To learn more on the topic, watch the recording of the webinar, “How Value-Based Care Will Change Dentistry’s Future.”