Dental homes and the value of comprehensive care

The term “Dental Home” refers to an ongoing relationship between dentists and patients which includes all aspects of oral care that is provided in a comprehensive and coordinated way. Research demonstrates that members with a Dental Home are less likely to report unmet dental needs with this model. Although, the primary value of the Dental Home is the promotion a lifetime of good oral health with a trusted dental professional, there are many benefits for not only the member, but providers, health plans and other dental stakeholders. With Dental Homes, health plans and state administrations will see significant financial savings through coordination of member care that may be reinvested in other aspects of the benefit. They also encourage providers to incorporate Medicaid members into their practice in a coordinated way that works for their practice, increasing overall provider satisfaction and network participation. In addition to those listed above, there are several more benefits below:

Builds trust.
The key to a successful member experience often depends on trust. When a patient sees the same provider repeatedly, the communication process is more consistent and trust increases. In addition, patients and providers develop a mutual understanding of each other’s goals for treatment which leads to better outcomes and an enhanced patient experience. The Dental Home provides a mechanism for multiple dental visits over time that leads to increased confidence in the dentist, their staff and the care they are receiving.
Medical-dental integration.
It is well known and accepted that dentists often play a key role in identifying other non-dental health problems among their patients. Diseases like high blood pressure, diabetes, certain types of cancer, and autoimmune diseases like Lupus and Sjogren Syndrome may be identified in the dental office through direct testing or observation of oral manifestations. Since the Dental Home provides an opportunity for dentists to see the same patient two or more times a year, they are more likely to see changes in overall health that may need further assessment and potential treatment by a primary care physician or specialist. This becomes even more important as America’s population ages and more people develop chronic diseases. As we look to the future, there will be increased medical-dental integration, providing the best of both worlds to patients.
Reduction in total cost of care.
With healthcare costs soaring, Dental Homes are a way to decrease cost while improving care. The ability to review the patient’s dental history and previous x-rays is critical. It gives the dental provider more information on a patient’s dental history, previous procedures performed, and prior treatment recommendations which avoids duplication of procedures and unnecessary services that increase costs. Further, the Dental Home reduces the occurrence of more serious and costly dental procedures by early detection and treatment of urgent dental conditions.
Reduction in emergency care.
As noted above, research has shown that patients who have a usual source of dental care are less likely to report unmet dental needs, but they are also less likely to use the emergency room for urgent dental situations. Emergency room use for common dental problems such as swelling, pain from tooth decay, or a broken tooth is very expensive and usually results in prescriptions for antibiotics and/or opioids with no procedural treatments at all. Further, hospitals and ERs often lack appropriate personnel to treat dental emergencies and patients are left to find dentists on their own. A research brief from the American Dental Association estimated that ER costs for dental complaints topped ~$2.1 billion in 2010 and ~1.7 billion were avoidable costs where treatment could have been rendered in a dental office. With a Dental Home assignment, members will have the name and contact information of a local dental office where they can have their concerns addressed and will not rely on the ER for care. Overall, the member will receive more appropriate care with reduced costs for health plans and state administrators.
Improvements in quality of care.
Every dental provider wishes to deliver the best care possible in the most efficient way. The medical industry has moved quickly to a value-based model which focuses on both quality and lower costs, with dental poised to follow in their footsteps The Dental Home provides a model that focuses on providing better long-term dental health along with a better experience for patients, with significant potential to positively impact physical and mental health. Procedures become more routine, serious dental problems are largely avoided, and overall oral health is promoted.

At Delta Dental, we are cognizant of the needs of our state administrators and health plan partners to increase benefit utilization, reduce costs associated with dental ER claims and increase access to care. Core contract language is now emphasizing care coordination, adequate networks and innovative ways to increase utilization; often with financial penalties associated if the health plan fails to deliver. While Dental Homes are not a new concept for dental plan administration, our model will be expanded in scope and contain unique ideas to build upon this framework. Our Dental Home process will see Members assigned to a particular provider within their communities or with one they have received care from in the past. This process will remove the barrier of finding a dentist so the member will access care more quickly and efficiently. In addition, Delta Dental will increase the number of mobile dental providers to reach members in rural and underserved areas in cooperation with our community partners. For the providers in our network, we will allow customization of their member roster to be assigned as few or as many members as they choose. This ensures that providers can effectively schedule and treat their assigned members without becoming overwhelmed, which leads to increased provider satisfaction. The customization process also allows the provider community to be more proactive with their Medicaid patients by viewing their roster and sending care reminders as necessary which in turn, will increase utilization. The opportunity to remove barriers and work collaboratively with providers in other disciplines is an important goal for improving oral health access, and Delta Dental is happy to assist. Our priority is ensuring quality care and timely access for all of our members, especially the underserved.