Federal Health Centers Well-Positioned to Adopt Value-Based Care

Federally Qualified Health Centers (FQHCs) may benefit from embracing value-based care, according to results from a research paper coauthored by the DentaQuest Partnership for Oral Health Advancement and the National Association of Community Health Centers (NACHC). The data is part of growing evidence that oral integration is critical to providing holistic care.

When COVID-19 affected that manner in which dental care is provided, FQHCs were able to respond by adopting telehealth services, and being flexible in regard to staffing and testing capacity. It was this flexibility that reinforced NACHC’s decision to endorse value-based care for oral health across its more than 1,400 FQHCs nationwide. The DentaQuest Partnership’s approach to a value-based care national model includes using telehealth and implementing value-based tools for prevention, better disease management, and positive overall health outcomes.

In the white paper, “Oral Health Value-Based Care: The Federally Qualified Health Center (FQHC) Story,” researchers assessed dental utilization data of FQHCs against their Medicaid private practice counterparts. The analysis focused on metrics related to a value-based approach, such as rate of preventive service delivery, use of caries risk assessment, and care of patients with chronic conditions, explains Rebekah Mathews, MPA, director of value-based care for the DentaQuest Partnership for Oral Health Advancement.

When compared to their private practice counterparts, FQHCs demonstrated strong rates of preventive service delivery, higher rates of performing risk assessments, and evidence supporting improved outcomes for patients with chronic conditions—all key elements of a value-based care model, says senior author Sean G. Boynes, DMD, MS, vice president of health improvement for the DentaQuest Partnership for Oral Health Advancement.

Researchers found adults receiving oral health services at FQHCs are more likely to have better diabetic health status. For every 1% increase in FQHC patients receiving dental services, the proportion of patients with uncontrolled diabetes declined 0.2%. A total of 12% of FQHC dental patients have a chronic condition, with 7% having either complicated or uncomplicated diabetes and 2% having cardiovascular disease.

“Overall, these findings indicate oral health is part of treating the whole patient, reinforcing the positive effect of a value-based care model that includes oral health,” says Boynes. “Such a model of care focuses on population health management, prioritizes prevention and minimizes invasive treatment, and enables care management for chronic conditions thanks to FQHC providers’ ability to access data and records for the shared patient base and their efforts to coordinate care needs.”

The use of teledentistry and employing minimally invasive treatments also showed the centers are well-positioned to respond to the COVID-19 pandemic, as patients can receive minimally invasive treatments and nonaerosolized procedures. These treatment options help mitigate exposure for clinicians, dental staff and patients.

“The report findings reinforce the connection between oral and overall health and the value of integrated care, something inherent in the FQHC model. Their infrastructure involves comprehensive dental and medical care, care coordination, data sharing, and alternative payment models—all of which makes FQHCs well-positioned to include oral health as part of overall value-based care efforts and ultimately influence others to do the same,” says Mathews.