Designing a Values Based Purchasing System for Oral Health

Through a HRSA funded State Oral Health Workforce grant, the Pacific Center for Special Care at the University of the Pacific Arthur A. Dugoni School of Dentistry (Pacific) directed the development of an “outcomes and value-based” payment mechanism that has the potential to allow California to purchase “more oral health per dollar” than it does at present.  This new model will incentivize the spread of community-based oral health delivery systems, the use of community-wide prevention tools, and the adoption of strategies to improve the oral health of the entire population. It will align payment incentives with desired oral health outcomes.  In collaboration with a group of partners and advisors, Pacific has created an actionable blueprint for a “value-based” payment mechanism that could be deployed in California’s dental Medicaid program.  This plan can be used to implement a pilot project where health plans would be rewarded based on the health outcomes of the populations they are contracted to serve.  The implications of creating an “accountable” and “outcomes and values-based” payment plan for the state’s Medicaid dental program are significant. 

As the oral health industry enters the “Era of Accountability” there is increasing attention being given to design of payment mechanisms such as this.  This session will describe the process used to develop the blueprint as well as the components of the resulting plan.