Mark J. Doherty, DMD, MPH, CCHP National Primary Oral Health Conference November 9-13,2008

1. Mission Accomplished: How to Treat Patients, be Sustainable, Meet Quality Indicators and Have Fun, Too Mark J. Doherty, DMD, MPH, CCHP National Primary Oral Health Conference November 9-13,2008

2. Well….. What is the Best Practice? • The one that manages itself well enough to provide quality treatment, maintains financial viability, completes its mission and is able to recruit and retain staff while having fun doing it.

3. Men are from Mars , Women are from Venus by John Gray • Medical Departments and Dental Departments are just as different as men and women • In order to be successful at running either…. one has to understand the basic environment of care for each. • Would you take the time to learn how to fly a plane before you take one up? Of Course! • What type of success should we expect if we try running a dental department before we understand all of the moving parts?

4. What's the First and the Second Rule ? • Think • Apply Yourself

5. What's the MOST important Consideration ? • Keep it Simple

6. This Ain`t Rocket Science

7. Why Recreate the Wheel?

8. Thimk! • Mission • Quality of care • Needs • Staffing to meet needs • Expenses • Payer Mix • Chaos or control

9. Apply Yourself • Strategic Plan • Leadership • Information • Pick the low hanging fruit • Build success early • Share your success • Be creative

10. Let's Start • Be Real…..Let's be practical • In order to apply yourself you have to know your practice. • Data does not lie. • Information is knowledge and knowledge is power • The first step in getting to know your practice is gathering your data.

11. The Key Data • Visits • Gross Charges • Net Revenue • Expenses • No-Show Rate • Emergency Patient visits • Transactions by ADA code • Completed Phase I Treatment Plans • Payer Mix of the practice

12. What can that DATA tell us???? • It tells us if Expenses are greater then Revenue • It tells us the cost per visit [expenses/visits] • It tells the revenue per visit [revenue/visits] • It tells us if we are accomplishing our mission [completed treatments] • It tells us if we are controlling chaos [%no-Shows, #emergencies] • It tells us what our opportunities are [payer mix] and how well we are using the mix to expand our access.

13. What do we do with the data? Share It

14. Think and Plan at the level of the visit

15. The visit is what we understand • Clinically • Financially • Strategically • Practically

16. The Visit • Build and create strategic plans around the visit • Eliminate chaos involved with the visit • Create business plans using the visit as the basic building block

17. HRSA`s Role • Support • Guidance • Education • Motivation • Learning Community • Communication

18. Quality Indicators • Completed Phase I treatment plans: More emphasis on completed treatments as an indicator of program quality, disease elimination and disease management • High Phase I completion rates is a quality indicator for better patient population service • The more patients we complete the more new patients we can introduce to the practice. • Completed treatments is a well understood goal by staff and an action step in many strategic plans

19. What is Phase I One Treatment? • Diagnostics • Preventive services • Treatment and elimination of disease • Extraction of Hopeless teeth • Help patients achieve a baseline of normal disease free oral health

20. What Best Practices Aid in the Completion of Phase I Treatments ? • Decreased No Shows • Defined and controlled care of Emergencies • Scheduling practices that optimize the timely completion of needed treatment. • Protocols directed toward the completion of Phase One Treatment. [Think!] • Program budgets with a 330 grant oral health allocation listed and utilized in the strategic plan to complete treatments

21. Completed Phase I Treatments as a Performance Measure Gives us a measure as to how well we are completing our mission Helps us identify strategies which help us complete treatments as well as those that impede progress Completed treatments fulfill two major criteria: • Creating more access by provision of more appointments for new patients • Stabilizing the oral health status of our patients by treating and eliminating disease. Completed treatments as a quality measure helps limit or eliminate “churning” as a practice strategy

22. Monitoring Phase I Completion Rates • A Quality Indicator for Disease Elimination and Management • Utilized across the CHC network as a benchmark at the local, state and national level for completed treatments in a timely manner • With a benchmark CHC practices will be able to share contributing and restricting factors to timely completion rates. • Encounter rates will be attached to completed treatments as a measure of success. • High rates = better population service

23. “Tracking our Dental Program’s Treatment Plan Completion rate” Phase 1 Therapy A Clinical Outcome Measure Alexandra L. Chan DDS,MPH Hill Health Corporation Director of Dental Services New Haven, Derby Connecticut

24. Safety Net Solutions Partnering to Strengthen and Preserve the Oral Health Safety Net http://www.catalyst-safetynetsolutions.org