Over the last several years, the medical field has moved toward value-based care to reduce costs and improve patient outcomes. For the most part, oral health has been left out of the conversation. But dentistry is starting to follow suit by emphasizing prevention-focused oral health care and incentivizing providers for keeping patients healthy. A key driver in the success of value-based care is aligning new payment models that reward care and outcomes and not the volume of services. More than 40 states are working to adopt value-based payment initiatives, up from just 15 in 2014.
For more than two centuries, dentists have practiced in a fee-for-service (FFS) reimbursement environment. In this model, dental providers get paid for the number and types of procedures they perform. More invasive and restorative procedures are reimbursed at higher rates than preventive procedures. We need to fix this broken reimbursement system.
In the value-based care model, payers reimburse providers based on the quality of care instead of the volume of care. The expectation is that payers will eventually move away from a fee-for-service (FFS) reimbursement model towards alternative value-based payment models, such as capitation or global payment; bonus and incentive payments; and shared savings models with or without shared risk.
Learn more about Payment Reform
The U.S. health care system is in the process of reforming its payment structure to incentivize quality, health outcomes, and value of care over volume of care. In this module, you’ll take a look at what has been happening in medicine and how it can be applied to dentistry. You’ll learn about payment reform priorities in both medicine and oral health care and the opportunities and barriers to implementing them. By the end of the module, you’ll have a better understanding of alternative models of reimbursement that can support a prevention-based model of care in your own practice, leading to improved patient experience, better oral health outcomes, and more manageable costs.
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This free Online Learning Module offers continuing education credits.
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