Patient-Centered Dental Home Development Project: Phase 1 Study Methodology

Recent changes in the health care system, including passage of the Affordable  Care Act, have transformed the delivery of health care in the U.S. Changes include an emphasis on coordinated care that incentivizes value over volume. These incentives have led to the creation of health home models, including expanded use of the patient-centered medical home (PCMH), that connect
primary care to other facets of health care such as primary mental health and secondary specialist care.

There is a need for similar care coordination within dental care delivery systems and for integration of dental health care within these new health home models. Within dentistry, there is no standardized definition of the dental home concept, which to date has focused primarily on access to care among children. Moreover, there are few examples of integration of the dental home into broader systems of care; existing efforts have largely focused on the provision of preventive dental care in primary medical care settings. However, there is a need to integrate all dental services, including both prevention and treatment, for both children and adults within health home models. This is supported by the mounting evidence on the association between oral and systemic health across the lifespan.

To facilitate improved coordination and integration, there is a need for oral health service models that emphasize patient-centered care and improved outcomes rather than the volume of services provided. To address these needs, the University of Iowa Public Policy Center convened a National Advisory Committee in 2015 to develop a measureable PCDH model that adopts the foundational elements of, and is positioned to integrate with, the PCMH. This new model aims to improve patient care and health outcomes and to facilitate the integration of dentistry with broader systems of care.