Dental Practice Integration into Primary Care: A Microsimulation of Financial Implications for Practices

Sung Eun Choi, Lisa Simon, Jane R. Barrow, Nathan Palmer, Sanjay Basu and Russell S. Phillips
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Sung Eun Choi: Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA 02115, USA
Lisa Simon: Office of Global and Community Health, Harvard School of Dental Medicine, Boston, MA 02115, USA
Jane R. Barrow: Office of Global and Community Health, Harvard School of Dental Medicine, Boston, MA 02115, USA
Nathan Palmer: Department of Biomedical Informatics, Harvard Medical School, Boston, MA 02115, USA
Sanjay Basu: Center for Primary Care, Harvard Medical School, Boston, MA 02115, USA
Russell S. Phillips: Center for Primary Care, Harvard Medical School, Boston, MA 02115, USA

IJERPH, 2020, vol. 17, issue 6, 1-13

Abstract: Given the widespread lack of access to dental care for many vulnerable Americans, there is a growing realization that integrating dental and primary care may provide comprehensive care. We sought to model the financial impact of integrating dental care provision into a primary care practice. A microsimulation model was used to estimate changes in net revenue per practice by simulating patient visits to a primary dental practice within primary care practices, utilizing national survey and un-identified claims data from a nationwide health insurance plan. The impact of potential changes in utilization rates and payer distributions and hiring additional staff was also evaluated. When dental care services were provided in the primary care setting, annual net revenue changes per practice were −$92,053 (95% CI: −93,054, −91,052) in the first year and $104,626 (95% CI: 103,315, 105,316) in subsequent years. Net revenue per annum after the first year of integration remained positive as long as the overall utilization rates decreased by less than 25%. In settings with a high proportion of publicly insured patients, the net revenue change decreased but was still positive. Integrating primary dental and primary care providers would be financially viable, but this viability depends on demands of dental utilization and payer distributions.

Keywords: integrated care; medical–dental integration; simulation model; dental research (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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