Dental Care is the Missing Piece of Population Health Management

Dental Care is the Missing Piece of Population Health Management

Dental care often falls by the wayside for high-risk patients, but better integration with existing population health management programs could improve outcomes.

The care continuum may be drawing closer together as value-based care creates new business cases for population health management, yet one segment of the healthcare delivery system has been chronically left out of the loop.

Though they provide critical preventive services that have wide-ranging impacts on clinical health, dental care providers are still relegated to the fringes of the patient-centered ecosystem.

On the consumer side, dentists have been fighting a bad rap for decades.  Separate insurance protocols, which often require significant out-of-pocket expenses, along with inadequate patient education and negative perceptions about treatment options and the potential for discomfort, have contributed to cultural stereotypes of the dentist’s office as a place to fear, dread, and avoid.

Within the provider community, low participation in meaningful use, different record-keeping needs, and a unique set of health IT vendors have kept dentists technologically separate from the rest of the clinical spectrum, while limited collaboration and coordination with primary care providers has largely left dental health off the checklist for patient-centered preventive care.

But dodging or delaying dental care can have significant impacts on overall patient wellness, and may lead to more expensive, invasive, and painful procedures down the line.  Dentists can act as the first line of defense for the prevention and detection of oral cancers, gum disease that results in bone loss, and difficult-to-treat infections that start in the teeth and jaws.

They can also contribute significantly to the health system’s understanding of socioeconomic patterns of chronic disease and patient activation, since poor oral health often goes hand-in-hand with lower levels of education, restricted access to care, and lower rates of health insurance coverage.

Patients with at least some college education are nearly three times more likely than those without a high school diploma to visit the dentist, according to data from Healthy People 2020, and are equally less likely to suffer from destructive periodontal disease.

Privately insured consumers access dental care more than twice as often as the uninsured, and they are 20 percent more likely to have regular contact with a dentist than those using public insurance programs, which may contribute to long-term disparities in outcomes for certain cancers.

With dental caries and periodontal disease ranking as two of the most common chronic conditions among children and adults, surpassing the national rate of diabetes, it may be time for the healthcare industry to reassess the position of dentists and other oral healthcare providers within the population health management environment in order to deliver truly comprehensive care to patients.

Examining the medical-dental health IT divide

While many dentists qualified for either the Medicare or Medicaid EHR Incentive Programs, few ended up participating in the federal push to increase health IT adoption for eligible providers and hospitals.

As of October 2016, just 272 dentists received payments within the Medicare EHR Incentive Program, complemented by much more significant participation on the Medicaid side of meaningful use, with nearly 21,000 unique providers getting paid for one or more years of successful attestation.

Compared to more than 300,000 physicians across both programs, dental adoption of certified EHR technology spurred by federal incentives has been extraordinarily modest.

Read full article at