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Accuracy in Dental Medicine, A New Way to Measure Trueness and Precision
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Pay-for-performance incentive program in a large dental group practice.

Douglas A Conrad, Peter Milgrom, R Mike Shirtcliff

    Journal of the American Dental Association (1939)
    |March 13, 2018
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    Summary
    This summary is machine-generated.

    This study introduces a pay-for-performance (P4P) incentive program for a large dental practice serving Medicaid patients. Implementing this system presented administrative challenges that require ongoing adjustments for workforce support.

    Keywords:
    Compensationdental care deliveryfinancial incentivesmanaged dental carequality improvement

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    Area of Science:

    • Dental Practice Management
    • Healthcare Economics
    • Health Services Research

    Background:

    • Growing trend of dentists in large group practices utilizing financial incentives.
    • Focus on a large, capitated Oregon dental practice primarily serving Medicaid beneficiaries.
    • Introduction of a pay-for-performance (P4P) incentive program is described.

    Purpose of the Study:

    • To describe the design and initial implementation of a P4P incentive program.
    • To address the complexities of incentivizing providers and staff in a large group dental setting.
    • To lay the groundwork for future effectiveness assessments.

    Main Methods:

    • Utilized data from care files and electronic health records.
    • Incorporated provider, staff, and community surveys and interviews across 6 counties.
    • Implemented quarterly individual- and team-level incentives based on 3 key performance metrics.

    Main Results:

    • Encountered significant administrative challenges in program design and rollout.
    • Key issues included diverse provider/staff needs, metric setting, information systems, and workforce education.
    • Ongoing adjustments are being made to the incentive scheme to address identified challenges.

    Conclusions:

    • This is the first reported P4P compensation system for dental providers and staff.
    • Addressing complex administrative challenges is expected to take several years.
    • Successful implementation requires workforce support for P4P systems in large dental organizations.