Business Barriers and Opportunities for Transforming to Preventive Care to Treat Early Childhood Caries.

Abstract

Primary, secondary, and tertiary preventive dental services have the potential for achieving the triple aim of better health outcomes for populations, better patient experience of care, and lower per capita costs. Yet, maximization of preventive services has not occurred in dental practice nor been promoted by dental plans. While the lack of such things as diagnostic codes, caries classification systems, and validated risk assessment tools are barriers to increasing preventive care, they may not be the primary barriers that need to be addressed. The purpose of this paper was to focus on three issues: (1) the dental care business model based on a value proposition of surgical care rather than preventive care; (2) the benefit plan design that undervalues or does not cover effective primary, secondary, and tertiary preventive services; and (3) the current financial crisis in health care. It is the business model of dental practice and the benefit design of payers that are the biggest barriers that will have to change to transform dental care into a more effective and efficient means of achieving and maintaining health.