Dataset Information

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

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.

SUBMITTER: Choi SE

PROVIDER: S-EPMC7175120 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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

Choi Sung Eun SE Simon Lisa L Barrow Jane R JR Palmer Nathan N Basu Sanjay S Phillips Russell S RS

International journal of environmental research and public health 20200324 6

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-iden ...[more]

PMID: 32213882

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Project description:BACKGROUND:Burnout among primary care physicians, advanced practice clinicians (nurse practitioners and physician assistants [APCs]), and staff is common and associated with negative consequences for patient care, but the association of burnout with characteristics of primary care practices is unknown. OBJECTIVE:To examine the association between physician-, APC- and staff-reported burnout and specific structural, organizational, and contextual characteristics of smaller primary care practices. DESIGN:Cross-sectional analysis of survey data collected from 9/22/2015-6/19/2017. SETTING:Sample of smaller primary care practices in the USA participating in a national initiative focused on improving the delivery of cardiovascular preventive services. PARTICIPANTS:10,284 physicians, APCs and staff from 1380 primary care practices. MAIN MEASURE:Burnout was assessed with a validated single-item measure. KEY RESULTS:Burnout was reported by 20.4% of respondents overall. In a multivariable analysis, burnout was slightly more common among physicians and APCs (physician vs. non-clinical staff, adjusted odds ratio [aOR]?=?1.26; 95% confidence interval [CI], 1.05-1.49, APC vs. non-clinical staff, aOR?=?1.34, 95% CI, 1.10-1.62). Other multivariable correlates of burnout included non-solo practice (2-5 physician/APCs vs. solo practice, aOR?=?1.71; 95% CI, 1.35-2.16), health system affiliation (vs. physician/APC-owned practice, aOR?=?1.42; 95%CI, 1.16-1.73), and Federally Qualified Health Center status (vs. physician/APC-owned practice, aOR?=?1.36; 95%CI, 1.03-1.78). Neither the proportion of patients on Medicare or Medicaid, nor practice-level patient volume (patient visits per physician/APC per day) were significantly associated with burnout. In analyses stratified by professional category, practice size was not associated with burnout for APCs, and participation in an accountable care organization was associated with burnout for clinical and non-clinical staff. CONCLUSIONS:Burnout is prevalent among physicians, APCs, and staff in smaller primary care practices. Members of solo practices less commonly report burnout, while members of health system-owned practices and Federally Qualified Health Centers more commonly report burnout, suggesting that practice level autonomy may be a critical determinant of burnout.

Dataset Information

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

Publications

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

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