Health Transformation Programs
We collaborate with public and private stakeholders and support individuals, communities, and health systems to create person-centered, integrated systems of care that lead to better health outcomes.
MORE Care (Medical Oral Expanded Care)
MORE Care® was a 10-year initiative of CareQuest Institute (2015-2025) that aimed to integrate oral health competencies and capabilities into primary care offices while building patient-centered referral networks with local dental providers using health information technology.Â
The MORE Care ProcessÂ
Using a Breakthrough Series Collaborative model, MORE Care worked within communities to establish interprofessional oral health networks (IPOHNs) to integrate person-centered oral health care.Â
State-based partners worked with local dental providers and organized dentistry to cultivate referral relationships, helping patients seen in the primary care practice get dental care, too. Dental and primary care teams worked together to establish open lines of communication that promoted shared goals and comprehensive care for their patients.Â
The MORE Care framework focused on health information technology to facilitate interprofessional practice.Â
Phase 1 Pilot: The South Carolina Experience (2015)
Through a partnership with the South Carolina Office of Rural Health and Medical University of South Carolina, we piloted the integration of oral health into primary care and built dental care referral networks. Six rural primary care practices participated in a 12-month learning collaborative to test strategies for optimizing systems in their practices to support the delivery of oral health preventive services and coordinate care to dental.Â
Phase 2 Pilot: The Pennsylvania and Colorado Expansion (2016)
Drawing from the experience and knowledge gained during the Phase 1 pilot, MORE Care expanded to two new states, partnering with the Colorado Rural Health Center and the Pennsylvania Office of Rural Health to support 17 rural primary care sites. The goal of Phase 2 was to further test oral health integration strategies and the development of dental referral networks in new environments of care to determine feasibility, challenges, and successes.Â
Phase 3 Pilot: Virginia Expansion Pilot & Central Oregon Experience (2019)
We then adapted and piloted the MORE Care model in Virginia, in collaboration with Virginia Health Catalyst, and in Oregon, with Central Oregon’s CCO (coordinated care organization) environment. In Oregon, in particular, the health care landscape helped establish an interoperative health information technology solution to facilitate interprofessional practice. This unique opportunity provided timely insight into how medical and dental programs could coordinate care effectively to improve health outcomes.
Phase 4 Pilot:  Supporting Integrated, Value-Based Care in Ohio (2021–2022)
Through a consensus-building project led by Oral Health Ohio, local stakeholders identified MORE Care as a framework to support advancing integrated, value-based care in Ohio that was inclusive of oral health. The initiative brought together seven private and health-system-affiliated practices to expand access to preventive dental services for nearly 20,000 children. The lessons learned in the report and case study offer a roadmap for scaling medical-dental integrationÂ
Community Oral Health Transformation (COrHT)
Community Oral Health Transformation was a CareQuest Institute-led initiative, from 2020 – 2024, that provided a framework for safety net dental clinics that:  Â
- Made care more accessible to individuals in underserved communities through innovations like telehealth.Â
- Focused on prevention and minimally invasive care, including fluoride applications.Â
- Integrated dental care with medical care to treat the whole person.Â
We collaborated with safety net dental clinics, supporting them with the tools and resources they need to incorporate the Three Domain Framework to transform the health of their communities. In states where the initiative had already been tested, participating clinics achieved their goals to improve patient outcomes, improve experiences for both patients and providers, and lower health care costs.Â
2020
Massachusetts: Continuing Care During a PandemicÂ
CareQuest Institute created COrHT during the COVID-19 pandemic, helping to continue the delivery of oral health care to patients of FQHCs in Massachusetts. Â
Learn more about the experiences and outcomes in Massachusetts.Â
2021Â
Ohio and Arizona: Preparing for Value-Based Payment Systems
In Ohio and Arizona, COrHT expanded on knowledge learned in Massachusetts to increase adoption of the Three Domain Framework and prepare teams for a value-based payment system. Â
Following the initiative, participants reported positive outcomes including increased silver diamine fluoride (SDF) applications, increased completion of Caries Risk Assessments (CRAs), as well as heightened patient awareness, repurposed provider time, and more integrated workflow. A majority (84%) of participants said they felt confident in their knowledge about the clinical care components of oral health value-based care because of their participation.Â
2021
Ohio and Arizona: Preparing for Value-Based Payment Systems
In Ohio and Arizona, COrHT expanded on knowledge learned in Massachusetts to increase adoption of the Three Domain Framework and prepare teams for a value-based payment system. Â
Following the initiative, participants reported positive outcomes including increased silver diamine fluoride (SDF) applications, increased completion of Caries Risk Assessments (CRAs), as well as heightened patient awareness, repurposed provider time, and more integrated workflow. A majority (84%) of participants said they felt confident in their knowledge about the clinical care components of oral health value-based care because of their participation.Â
2022
North Carolina: A Value-Based Approach to Equitable Oral Health CareÂ
A partnership between the North Carolina Oral Health Collaborative, CareQuest Institute, and Blue Cross Blue Shield of North Carolina Foundation established a learning community of safety-net dental clinics to share best practices, support a network of champions for change management, and advance policy change.Â
2022
Michigan: Building Confidence and Capacity in Value-Based CareÂ
In Michigan, COrHT brought together executive and clinical leadership from three health centers to use their resources to deliver comprehensive patient care, inclusive of oral health, and increase confidence and capacity to engage in value-based care. Â
The learning community focused on developing sustainable business models that prioritized oral health, expanded patient engagement and community partnerships, and elevated the utilization of data and oral health measures.Â