Patients trust their dentists. Dental organizations and practices want to use that trust to make the dental chair a checkpoint for patients’ overall health.
Jamie Clarke, senior vice president of provider strategy of Delta Dental of California and affiliates, which operates in 15 states and Washington, D.C., spoke with Becker’s about what full medical-dental integration could look like for patients and providers, and what still stands in the way.
The payer has been laying groundwork for that shift. It collaborates with the American Heart Association on Healthy Smiles, Healthy Hearts, an initiative that gives dental teams tools to screen patients’ blood pressure and refer them for medical follow-up, and is working with Epic to connect dental records with medical records.
Editor’s note: Responses have been lightly edited for length and clarity.
Question: If we get to full medical-dental integration, what does a dental visit look like five years from now, for patients and providers?
Jamie Clarke: It’s really about redefining the oral health visit as a preventive touchpoint. Providers would ask about more than oral health; they’d ask about overall health, and members would be educated to expect that.
Our research shows members trust their dentist. When we asked them, through our work with the American Heart Association, how they’d feel about getting their blood pressure checked in the dental office, they were very receptive. So how do we make that normal? Your primary care doctor checks your weight and blood pressure. What makes the most sense to also do in the oral health visit, so it’s considered a preventive visit and referrals are happening?
When something is found, dental should be part of the community of care. It wouldn’t be unusual to have a referral pattern to a cardiologist or primary care, or to ask members whether they actually have a primary care provider. Millions of Americans go to the dentist but don’t have a medical home. We need to give our dental clinics the tools and resources to connect members to care locally, and create a connected community of medical and dental professionals.
It has to go the other way, too. We need to normalize the primary medical home asking about oral health and when patients last saw a dentist, and educate primary care providers on how oral health affects physical health. In five years, what’s done in a dental clinic, and what patients expect, would look really different.
Q: Medical and dental coverage are still bought separately. Where does that fit?
JC: Even the way we purchase insurance is different. That segmentation exists, and we have deep expertise in dental insurance that we believe is important to maintain. But we’re also thinking about how to connect, and our relationship with Epic is one example. How do we keep the purchasing of insurance from interfering with the ability to have connected, single health records? It doesn’t have to be as bifurcated as it is.
Q: What other hurdles need to be cleared before care is truly integrated?
JC: We need to make administration easier for practices. There are significant workforce shortages in dentistry, and one more thing to do seems daunting. So how do we help practices create capacity without increasing their overhead? We’re going digital and working on how providers can optimize their experience with us so we can show the value we’re creating. Hopefully that gives them the capacity to take these things on.
We also need to better educate them on the value of doing this in their practice, in terms of what matters to them: patient retention, trust, referrals. One of the dentists on the panel talked about his work with the AHA, doing blood pressure monitoring in his office. It resulted in far more than he expected. More people were referred to him, and physical health providers started referring patients to him once they realized what he was doing. We have an opportunity to showcase that value, so practices want to do these things.
So a few things need to happen. We as insurers need to be really easy to work with, we need to help create capacity and we have to own the narrative on why this creates value for their clinic.
