Lessons From the Pandemic: What COVID-19 Is Teaching Us About Value-Based Care
By Steve Pollock, DentaQuest President and CEO and Rebekah Mathews, Director of Value-Based Care, DentaQuest Partnership for Oral Health Advancement
Long before the coronavirus pandemic, many parts of the U.S. health care industry have been moving — some faster than others — toward value-based care delivery and value-based payment models. While dentistry continues to lag primary care on the shift from volume to value, the pandemic has forced many dentists and oral health providers to seriously consider the short- and longer-term benefits of making this shift. Now, more than ever, we need to accelerate our efforts if we are going to emerge from the pandemic with a strong and resilient oral health system.
So, what has COVID-19 taught us about value-based care?
Education Is Critical
COVID-19 has dramatically shifted the delivery of oral health care, and many of the changes we’ve experienced will make lasting impacts on the industry and our national provider network. We are working hard to educate dentists and other oral health providers about the best ways to continue delivering safe and high-quality care — and how to respond to changes, including those associated with value-based care.
For more than a decade, the DentaQuest Partnership for Oral Health Advancement has led the way in providing free educational offerings, including a value-based care readiness assessment tool and a series of online value-based care learning modules through its online learning center. These resources are more important than ever, as dentists do their best to adapt to a changing environment and are looking for more online learning options. In response to this demand, we recently launched a five-part COVID-19 Education Series to help providers redesign care with a focus on infection control, COVID-19 testing and minimally-invasive care. And as dental practices move toward more regular operations, we’ll continue to work with our network providers to introduce new alternative models that align incentives to provide high-quality care in a sustainable cost structure.
Teledentistry Is an Important Enabler
State responses to the pandemic, including the closure of most dental practices and restrictions on the delivery of non-emergency care, created a spike in demand for telehealth solutions and teledentistry services. This triggered changes in the way care can be triaged, delivered and reimbursed during times of crisis that can be further leveraged post-pandemic.
And both patients and providers are interested. Our recent survey of patients who used teledentistry in Oregon showed that 86% said they were satisfied with their overall teledentistry experience, would use it again and would recommend it to another person. Our national survey of Medicaid dentists showed more than half of providers currently using telehealth platforms cited increased use of telehealth and other forms of noncontact dentistry as one of the long-term changes they expect to make as a result of COVID-19. This is important, not only because teledentistry can help deliver on the promise of value-based care by improving access and lowering costs, it can also create more convenient care experiences for patients. To support this change, the DentaQuest Partnership produced a series of webinars to help providers bring teledentistry into their practices and establish protocols that can support meaningful and lasting use of this tool.
DentaQuest is also expanding teledentistry capabilities for its DentaQuest managed or affiliated dental practices through a recent investment in a new teledentistry platform, and we will share what we learn across our provider network in the coming weeks and months.
Financial Realities Reinforce the Need for Change
COVID-19 has touched every industry and business, and dentists working in a traditional fee-for-service environment were hit particularly hard. In our recent provider survey, about 90% of dental providers reported decreases in patient visits during the pandemic with an average decline of 51% in volume. A similar number (89%) of providers reported that their practices received less revenue during the pandemic, and nearly 3 in 4 dental offices (72%) had laid off or furloughed staff because of the crisis.
That same survey showed that while patient visit volumes have started to increase in recent weeks, 93% of providers were concerned about long-term changes to dentistry and 72% anticipated ongoing reductions in patient volume. While alternative payment models, including population-based models like capitation with quality metrics, would not have prevented the decline in in-person patient visits, they could have helped lessen the negative financial impact on dental practices during the pandemic. And they can incentivize providers to continue caring for patients beyond the dental chair, leading to better overall oral health and providing more financial stability for oral health providers going forward.
COVID-19 has taught us a lot. It has also reinforced many of the things we already suspected or knew. At DentaQuest and the DentaQuest Partnership for Oral Health Advancement, we know that accelerating the shift to value-based care in oral health, including the adoption of more value-based payment models, is the right thing to do, and we will continue working with providers to make that shift.
Editor’s Note: For more information, visit https://www.dentaquestpartnership.org/care-improvement/oral-health-value-based-care.
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