News
New Survey Highlights Opportunities and Barriers to Value-Based Dental Care
By Mike Adelberg, NADP Executive Director
October 30, 2024
In one of my first Dental Impressions blogs, I discussed the win-win-win potential of value-based care:
- Patients have better health outcomes.
- Providers receive higher per-service reimbursement by embracing the most effective patterns of care.
- Payers and plans reduce the total spend by caring for healthier members and financing a more cost-effective mix of services.
I suggested that value-based care in medical care was a real revolution—but a revolution in slow motion. Nonetheless, at least one-fourth of America’s medical care is now delivered through a value-based model. I speculated that value-based principles likely can be applied to parts of dental care and noted a few promising limited scope projects underway. But, at the time, I did not know how dental plans and providers really felt about applying value-based principles to dental care. Now, I do.
This summer, NADP partnered with HealthScape Advisors and the CareQuest Institute for Oral Health to conduct a first-ever market survey and qualitative interviews of dental payers and multisite dental providers. The research assessed perspectives on, and experience with, value-based dental care models. The resulting report, Pathway to Value, released a month ago, provides an unprecedented examination of the opportunities and barriers that exist with regards to applying value-based principles to dental care.
I cannot do justice to the report in a short blog, but I will briefly call out a few findings:
- While there is no consensus “cookbook” for value-based dental care, there is some alignment between plans and providers on what the focus of that cookbook might be. Plans survey respondents most often associated value-based care with quality of care and improved oral health outcomes. Providers survey respondents most often associated value-based care with preventive care and improved oral health outcomes.
- Whether a plan or a provider, the size of an organization correlates with that organization’s interest in the adoption of value-based principles. Larger plans and larger providers were both more likely to be optimistic about adopting value-based models.
- While plans and providers had differing goals for what they wanted to see from value-based models, there was a common “zone of understanding” with respect to applying value-based models to better managing members’ periodontal disease and health conditions
- Plans and providers were also aligned on the value-based tools that can be most easily applied. Specifically, member steerage and bonuses tied to quality of care were named by both plans and providers as the best starting points for value-based dental care.
Survey results also hint at very real operational and cultural challenges that will limit the speed and scope of value-based care adoption. The foremost challenge is trust—plan and provider respondents both believe that the other party’s primary motivation for exploring value-based models is its financial gain. As we have seen from the gradual growth of value-based models in medical—trust is the largest single hurdle in value-based adoption.
The ultimate objective of the Pathway to Value survey is to promote dialog and illustrate where plans and providers might effectively collaborate in taking the first steps down the value-based pathway. NADP thanks Healthscape Advisors, the CareQuest Institute for Oral Health, and the many plans and providers that participated for their contributions to this first-of-its-kind survey.
