The Need for Defining a Patient-Centered Dental Home Model in the Era of the Affordable Care Act

The changing landscape of health care coverage and delivery has been influenced and accelerated by the Affordable Care Act (ACA). Initially, the emphasis of the ACA was on access to care with the expansion of public and private insurance coverage options. Gradually, the priorities shifted toward delivery system changes, influenced by value-based payment models and the associated need for more coordinated, population-based care.

Similarly in dentistry, the first efforts under the ACA were devoted to improving financial access to dental care by expanding public and private dental insurance. More recently, increased emphasis has been placed on improving dentistry’s integration into the overall health care delivery system. This highlighted the need for a model demonstrating 1) how dental care should be provided in a coordinated manner within a given practice setting, and 2) how oral health can be integrated into broader health home models. In dentistry, the concept of a dental home has primarily been focused on access to dental care for young children, and there is no standardized definition for the concept or how it should be evaluated. This elucidated the need to both broaden the concept to include populations of all ages, as well as to identify a definition and measurement method that is consistent across all organizations. We propose the patient-centered dental home (PCDH) as a model for providing coordinated, patient-centered dental care that can be integrated with broader health home models.

To help understand and prepare for changes in the delivery system for dentistry, this report provides background information describing how the patient-centered medical home (PCMH) model developed, how the ACA accelerated PCMH initiatives, and the intersection between ACA-related changes and opportunities to develop the PCDH model.