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Please see the report, which was
released Thursday and is available on the web sites of the W.K. Kellogg
Foundation here:
http://www.wkkf.org/news/Articles/2012/01/New-report-on-oral-health-quality.aspx
and the DentaQuest Institute here:
http://dentaquestinstitute.org/quality-improvement-initiatives/quality-improvement-an-era-accountability
Note from Dr. Reznik: There are several good points in the article and one
that is telling: "Oral Health Costs Making Dental Services Unaffordable for
Many
Dental expenses are now among the highest out-of-pocket health expenditures
for consumers. In 2008, they accounted for $30.7 billion or 22.2 percent of
total out-of-pocket health expenditures, second only to prescription
medications, according to the Bureau of Labor Statistics."
"Only through the exentension/reauthorization of the Ryan White Program will
we be able to continue to provide this much needed service to a very
vulnerable population."
WASHINGTON – As the country strives to improve its overall health care
delivery system, there is a push to make the oral health care delivery
system similarly accountable for quality and access. A new report funded by
the W.K. Kellogg Foundation and the DentaQuest Institute outlines an
approach to expand the oral health quality improvement effort through data
collection, accountability and new ways of delivering oral health care.
Although quality improvement in oral health lags behind similar efforts for
overall health, these efforts are intensifying. The report, Oral Health
Quality Improvement in the Era of Accountability, provides an overview of
current efforts and cites elements that are critical for advancing this
agenda: increased use of electronic dental records and integrated health
records; better measurement of oral health outcomes; new payment and
incentive mechanisms; and expanded delivery of care by non-dental
professionals, as well as new types of allied dental professionals.
The report – the latest in a growing number of analyses of the oral health
care system – was released this week at a national meeting of oral health
professionals, government leaders, consumer advocates and others convened by
the Kellogg Foundation and DentaQuest Institute that was intended to launch
a national dialogue on quality improvement and increased access to dental
care. The Institute of Medicine and U.S. Government Accounting Office
released reports on dental access and quality in 2011.
“The focus on quality improvement for overall health care is an important
opportunity to improve the quality of oral health care,” says study author
Paul Glassman, DDS, MA, MBA, director of the Pacific Center for Special Care
at University of the Pacific Arthur A. Dugoni School of Dentistry. “The
biggest problem now is we are developing many measures, but they need to be
connected to performance of the system. This report provides an opportunity
for a new dialogue on how best to collect and use data to improve quality
and increase access to affordable dental care.”
According to Glassman, the factors driving the focus on quality improvement
in oral health care – and the need to align payment incentives with health
care outcomes and value for patients – are the same ones driving the overall
health care quality movement:
- The increasing cost of oral health
care;
- An increasing understanding of the
unwarranted variability produced by the oral health system;
- Evidence of profound health
disparities in spite of scientific advances in care; and
- Increasing awareness of these
problems in the age of consumer empowerment.
The report also outlines the systemic
barriers that have slowed change:
- Limited evidence of best practice for
most dental procedures has led to widespread variation in clinical
decisions among dentists;
- Government only pays for about six
percent of dental care nationally, and dental practices and their patients
are not part of a larger provider organization pushing for improvements;
and
- Incentives to implement quality
improvement programs are few.
However, increasing costs, inadequate
access to care, and profound disparities are creating new pressures for the
oral health delivery system to focus on value instead of volume of services.
“With the current focus on quality improvement in health care, we need to
make sure that oral health isn’t left behind,” said Alice Warner, program
officer at the W.K. Kellogg Foundation. “Right now, 37 percent of
African-American children and 41 percent of Hispanic children have untreated
tooth decay, compared with 25 percent of white children. We need to do
better by all our children and this report provides ideas that can help lead
the way.”
Oral Health Costs Making Dental Services Unaffordable for Many
Dental expenses are now among the highest out-of-pocket health expenditures
for consumers. In 2008, they accounted for $30.7 billion or 22.2 percent of
total out-of-pocket health expenditures, second only to prescription
medications, according to the Bureau of Labor Statistics.
The keys to better access and quality are better measurement of oral health
care outcomes and promoting innovation at the systems level, says Glassman,
who suggests that the pathway to better measurement will involve:
- Increased use of electronic health
records to make collection and analysis of data easier
- Development and use of measures of
oral health outcomes
- Development and use of diagnostic
coding systems on oral health outcomes of populations
- Innovation in payment, monitoring and
incentive mechanisms tied to the oral health of the population served
- Improvements in oral health delivery
that include using chronic disease management strategies, delivering care
in nontraditional settings, developing new types of allied dental
professionals and engaging non-dental professionals in delivering services
- Use of telehealth technologies to
reach people in geographically remote areas
“The DentaQuest Institute is working
closely with clinical partners to implement quality improvement strategies
that emphasize prevention and disease management in dental care,” according
to Dr. Mark Doherty, executive director of the DentaQuest Institute. ”We
have begun to see success applying a disease management model to the care of
chronic disease.”
About the DentaQuest Institute
The DentaQuest Institute ( www.dentaquestinstitute.org)
is a not-for-profit organization focused on improving efficiency,
effectiveness and quality in dental care. The Institute works with clinical
partners across the United States to develop and implement more effective
approaches to preventing and managing oral diseases. For more information
about the DentaQuest Institute and its programs, visit
DentaQuestInstitute.org. The DentaQuest Institute is supported by DentaQuest,
a leading oral health company, administering prevention-focused dental
benefits to nearly 15 million individuals across the United States. The
report and related materials are available on the DentaQuest
Institute website.
About the W.K. Kellogg Foundation
The W.K. Kellogg Foundation, founded in 1930 by breakfast cereal pioneer
Will Keith Kellogg, is among the largest philanthropic foundations in the
United States. Based in Battle Creek, Mich., WKKF engages with communities
in priority places (Michigan, Mississippi, New Mexico and New Orleans),
nationally and internationally to create conditions that propel vulnerable
children to realize their full potential in school, work and life. To learn
more, visit www.wkkf.org or
follow WKKF on twitter at @wk_kellogg_fdn |
