Guest Opinions

Guest Opinion: Managed care is the answer for dentists and patients

Brush twice a day, floss twice a day and rinse twice a day. That is what we were all taught as children and told by our dentists twice a year.

While that advice still holds true, the business of being a dentist is changing and it is imperative that we dentists change with it — if we want to stay in the game.

Sixty percent of our country’s health care costs, and that includes dentistry, comes from government entities including Medicaid, Medicare, Veterans Affairs, cities, counties and state workers. Our current system can be classified as a fee for service to those who are sick — after they get sick, it is not working and is becoming unaffordable for everyone. The current sick care delivery system pays for the results of behaviors, which many times are caused by the illness or issue being treated. The model treats the sick and pays providers for the procedure that is immediately needed.

Take a cavity, for example; it may have been prevented with cleanings, but the infection was left to grow into a toothache that now requires a filling or crown. People are being treated for their illness after they are sick, and that is happening even more in dentistry. What we need is being described as a Triple Aim — better care, better health and better value.

At Advantage Dental, we are working with our network of dentists on the idea of disease prevention and finding a way to avoid expensive restorative procedures. We were formed to provide access to care of all the citizens in the communities we serve, and we are working hard to grow our network in rural Idaho communities, to ensure the best dental health care for residents. We work with the mouth, and now it is time to use our mouths to explain this more cost-effective approach that is already saving money for our neighbors in Oregon.

The process is starting with Medicaid recipients. It is a managed care model and it incentivizes participants through a monthly capitated payment. Managed health care is used to describe a number of techniques with the goal of reducing costs all while improving the quality of care for patients which result in better overall health.

Managed health care has been proven to be successful in a number of ways. We at Advantage Dental have a proven track record by managing our network of providers (dentists) and patients by:

1. First and foremost, promoting preventative care of our patients.

2. Identify a designated list of health care providers. Currently there are more than 400 dentists in our Idaho network, which is continuing to grow throughout the state.

3. Setting high standards for the dentists in our network.

4. Setting incentives to encourage our dentists to be the most efficient with their care.

There are a handful of dentists who provide care to these patients, but more and more dentists in private practice are going to have to make the change to some form of managed care as the future moves more toward the concept of disease prevention and finding ways to avoid expensive restorative procedures.

Remember, everything is changing, but what hasn’t changed is that we all have and need our teeth.

R. Mike Shirtcliff, D.M.D, is president of Advantage Dental.