American doctors will increasingly be paid according to the outcome of the healthcare services they deliver. Just seeing the patient will no longer be sufficient for payment by the insurer or Medicare/Medicaid. Rather, it is the results from medical services which matter.
Recently, a panel of federal government and insurers released seven groups of measures, each tailored to a type of care: cardiology, gastroenterology, HIV and hepatitis C, oncology, obstetrics and gynecology, orthopedics, and primary care.
Let’s look at what the primary care metrics are:
- whether patients’ blood pressure, depression and blood sugar levels were controlled;
- whether diabetic patients’ eyes and feet were examined;
- whether women were appropriately screened for cervical cancer and breast cancer;
- whether doctors unnecessarily screened females under 21 for cervical cancer;
- whether doctors screened patients for obesity and came up with a treatment plan and a follow-up visit.
The idea is that the physician must meet these metrics to receive payment in full.
So, how might this outcomes-driven reimbursement apply to dental care? Here are some possibilities for the insurers and government agencies to pay the dentist:
- whether the dentist asked the patient about his/her use of acidic-sugared foods such as colas and throat lozenges and counseled about avoiding these foods
- whether the dentist counseled diabetics, arthritic patients and those taking 3 or more prescription drugs per day, to manage the emerging bacterial infections on their teeth so as to avoid more dental surgery
- whether the dentist provided more prevention to those with recurrent need for surgery
The simple truth is that if insurers and governments want to reduce their cost of dental care for their clients, and improve outcomes at the same time, these simple measures for quality would go a long way.
For more, please visit: http://partnersinprevention.ca/improving-outcomes-from-dental-care/.
By: Ross Perry
SOURCED: Partners In Prevention – www.partnersinprevention.ca
