Abstract
Background: Dental practice has remained relatively insulated from payment upheavals in the broader health care system. The prevailing value-based payment (VBP) models in health care are largely absent in oral health care. The authors present an oral health care value-based payment framework for dentistry. Methods: The authors developed a VBP framework for oral health care, which describes 9 distinct methods to create VBP approaches in dentistry. The framework is based on the Centers for Medicare & Medicaid Services Learning Action Network framework for health care payment reform. Results: The oral health care value-based payment framework includes 4 payment categories and 9 separate payment mechanisms. These 9 payment mechanisms range on a value continuum, each with different financial risks and rewards as well as distinct value implications. Conclusions: Although dental practice has made extraordinary advances in restorative dentistry, payers and policy makers are advocating for greater value outcomes. VBP models seek to deliver better care more efficiently by means of providing oral health providers the resources needed to increase the value proposition. With relatively minor modifications in practice patterns, VBP models can be developed and implemented for oral health care. Practical Implications: This article can be used as a road map to take steps toward oral health care VBP approaches. The framework highlights how dentistry can learn from payment reforms under way in the health care system and present a model for oral health care payment and care delivery reform, and provides recommendations to advance oral health care VBP.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 178-185 |
| Number of pages | 8 |
| Journal | Journal of the American Dental Association |
| Volume | 150 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2019 |
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Keywords
- dental health care services
- health policy
- quality of care
- Reimbursement mechanisms
ASJC Scopus subject areas
- Dentistry(all)
Cite this
A framework for oral health care value-based payment approaches. / Riley, William; Doherty, Mark; Love, Kailey.
In: Journal of the American Dental Association, Vol. 150, No. 3, 01.03.2019, p. 178-185.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A framework for oral health care value-based payment approaches
AU - Riley, William
AU - Doherty, Mark
AU - Love, Kailey
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Background: Dental practice has remained relatively insulated from payment upheavals in the broader health care system. The prevailing value-based payment (VBP) models in health care are largely absent in oral health care. The authors present an oral health care value-based payment framework for dentistry. Methods: The authors developed a VBP framework for oral health care, which describes 9 distinct methods to create VBP approaches in dentistry. The framework is based on the Centers for Medicare & Medicaid Services Learning Action Network framework for health care payment reform. Results: The oral health care value-based payment framework includes 4 payment categories and 9 separate payment mechanisms. These 9 payment mechanisms range on a value continuum, each with different financial risks and rewards as well as distinct value implications. Conclusions: Although dental practice has made extraordinary advances in restorative dentistry, payers and policy makers are advocating for greater value outcomes. VBP models seek to deliver better care more efficiently by means of providing oral health providers the resources needed to increase the value proposition. With relatively minor modifications in practice patterns, VBP models can be developed and implemented for oral health care. Practical Implications: This article can be used as a road map to take steps toward oral health care VBP approaches. The framework highlights how dentistry can learn from payment reforms under way in the health care system and present a model for oral health care payment and care delivery reform, and provides recommendations to advance oral health care VBP.
AB - Background: Dental practice has remained relatively insulated from payment upheavals in the broader health care system. The prevailing value-based payment (VBP) models in health care are largely absent in oral health care. The authors present an oral health care value-based payment framework for dentistry. Methods: The authors developed a VBP framework for oral health care, which describes 9 distinct methods to create VBP approaches in dentistry. The framework is based on the Centers for Medicare & Medicaid Services Learning Action Network framework for health care payment reform. Results: The oral health care value-based payment framework includes 4 payment categories and 9 separate payment mechanisms. These 9 payment mechanisms range on a value continuum, each with different financial risks and rewards as well as distinct value implications. Conclusions: Although dental practice has made extraordinary advances in restorative dentistry, payers and policy makers are advocating for greater value outcomes. VBP models seek to deliver better care more efficiently by means of providing oral health providers the resources needed to increase the value proposition. With relatively minor modifications in practice patterns, VBP models can be developed and implemented for oral health care. Practical Implications: This article can be used as a road map to take steps toward oral health care VBP approaches. The framework highlights how dentistry can learn from payment reforms under way in the health care system and present a model for oral health care payment and care delivery reform, and provides recommendations to advance oral health care VBP.
KW - dental health care services
KW - health policy
KW - quality of care
KW - Reimbursement mechanisms
UR - http://www.scopus.com/inward/record.url?scp=85061612766&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85061612766&partnerID=8YFLogxK
U2 - 10.1016/j.adaj.2018.10.021
DO - 10.1016/j.adaj.2018.10.021
M3 - Article
C2 - 30803489
AN - SCOPUS:85061612766
VL - 150
SP - 178
EP - 185
JO - Journal of the American Dental Association
JF - Journal of the American Dental Association
SN - 0002-8177
IS - 3
ER -