In this article in Decisions in Dentistry, CareQuest Institute researchers update a previous analysis to compare spending and service utilization of fee-for-service (FFS) models to alternative payment models (APMs) through 2019. Consistent with earlier findings, cost per patient remains lower and service utilization remains higher under APMs compared to FFS.
The authors also found that patients in APMs are more likely to receive preventive services, like silver diamine fluoride and sealants, and less likely to visit the emergency department for a dental condition. The research analyzes dental care spending and utilization by Medicaid patients from ages 0 to 89.
Fee for Service vs. Value-Based Care
Rising health care costs have inspired new payment models that emphasize value and quality of care as alternatives to traditional fee-for-service models based on volume of care. Dentistry has been slower to adopt APMs compared to medicine — a recent provider survey shows that 51% of dental providers had never heard of APMs — but state Medicaid programs have been piloting dental APMs.
The authors conclude:
As awareness of, and experience with, value-based care and value-based purchasing grows in both medicine and dentistry, these trends are expected to gain momentum. It is vital that dentistry continues to adapt to shifts in payment transformation to create a more equitable, accessible, and integrated health system for everyone.
Read the article and take the CE course in Decisions in Dentistry
You may also be interested in:
- An Introduction to Value-Based Care in Oral Health: Moving from Volume to Value, a self-paced CE course that explains how VBC can improve patient outcomes while benefiting providers and payors.
- Pre-Doctoral Dental Faculty Perceptions Toward Value-Based Care, an article in the Journal of Dental Education that finds dental school faculty need more training and guidance to teach the concept of value-based care to dental students.
- Value-Based Care: The Federally Qualified Health Center Story, a white paper, developed in collaboration with the National Association of Community Health Centers, that discusses how FQHCs can lead the transformation into a value-based system.