Pay-for-performance in dentistry: what we know.
Little is known about the effect of a pay-for-performance system (P4P) on primary medical care providers and even less is known about its potential impact in dentistry. Based on the growing acceptance of performance-based reimbursements in medicine and the dissemination of innovative technologies, structures, and processes of care from medical to dental services, it is likely that the dental profession will face performance-based payments in the not-too-distant future. In this paper, we present the current experience of P4P in primary medical care that has relevance to dentistry and discuss the dental performance-based programs to date. Taking into consideration these lessons, the structure of dental service delivery in the United States, and the paucity of evidence-based quality indicators in dentistry, we provide several guidelines for the design of P4P pilot programs for dental services. We conclude that large-scale implementation of P4P for dentistry may not be a realistic option before significant progress is achieved in quality of dental care indicators.
Department of General Dental Sciences, University of Alabama at Birmingham, AL, USA. avoineagriffin@yahoo.com
Andreea
A
Voinea-Griffin
D Brad
DB
Rindal
Jeffrey L
JL
Fellows
Andrei
A
Barasch
Gregg H
GH
Gilbert
Monika M
MM
Safford
D003813:Dentistry / Q000592:standards*; D006291:Health Policy; D006801:Humans; D011785:Quality Assurance, Health Care / Q000191:economics*; D019984:Quality Indicators, Health Care; D012052:Reimbursement, Incentive; D014481:United States