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.
Comments