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The Future of Payment for Dental Care

Current Oral Health Reports volume 5, pages 147–153 (2018)Cite this article

Abstract

Purpose of Review

To examine the literature on dental reimbursement methods, with emphasis on paying for value (e.g., health care outcomes) rather than procedure. To make recommendations that would facilitate the expansion of access to dental care for those most in need and improve the oral health of the US population.

Recent Findings

Although the health care system is moving toward paying for performance and outcomes, dentistry lags behind. We review publications that identify obstacles to payment for outcomes in oral health as well as moving away from traditional fee-for-service reimbursement.

Summary

Payment for value in dentistry is a long way from becoming a reality; however, the testing of models within Medicaid that set aside a small percentage of the fee for a procedure to be reimbursed based on the improved oral health of the patient and/or the population of the practice may facilitate its adoption. A similar set aside in capitation-based programs could ensure the delivery of essential services and avoid the underutilization traditionally associated with this type of reimbursement system. Similar incentives could be tested in group practices and perhaps even community health centers. Widespread adoption of diagnostics code, missing in dental records, would enable better tracking of met needs. Educational systems that foster intra- and interprofessional teamwork and the appropriate use of personnel operating at the top of their competency would increase efficiency while adding value at the same or lower cost.

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Author information

Authors and Affiliations

  1. University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA

    Robert J. Collins

  2. Fort Myers, USA

    Robert J. Collins

  3. Los Angeles, USA

    Jay W. Friedman

Authors
  1. Robert J. Collins
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Correspondence to Robert J. Collins.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Dental Public Health

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Collins, R.J., Friedman, J.W. The Future of Payment for Dental Care. Curr Oral Health Rep 5, 147–153 (2018). https://doi.org/10.1007/s40496-018-0190-2

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  • DOI: https://doi.org/10.1007/s40496-018-0190-2

Keywords

  • Dental insurance
  • Diagnostic codes
  • Prepayment
  • Fee-for-service
  • Capitation
  • Reimbursement
  • Pay for performance (P4P)
  • Value-based payment
  • Health care outcomes