Population-centered Risk- and Evidence-based Dental Inter-professional Care Team

Study Overview
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Brief Summary
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The main goal of the payment and delivery system reform is to reduce disparities in oral health and dental care access of low-income mothers and children living in rural Oregon counties. The target population is children, pregnant women and new mothers enrolled in Oregon Health Plan (OHP) in rural Oregon.

Detailed Description
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To implement a payment plan model based on global budgeting and Alternative Quality Contract (pay-for-performance) for dental providers within Advantage Dental Services, LLC with the goal of incentivizing implementation of delivery system changes aimed at reducing disparities in access and oral health for low-income mothers and children living in rural Oregon counties. To implement delivery system changes where a team of dental providers (dentists, dental hygienists, case managers, community outreach workers and others) within Advantage Dental Services, LLC provide evidence-based screening, risk assessment and primary preventive care in non-conventional community settings (WIC, Head Start and similar settings) and seamless, timely and appropriate evidence-based care in Advantage dental clinics. To evaluate and document the payment and delivery system changes to assess whether the changes result in (1) reductions in disparities in access for low-income mothers and children; (2) efficiency in allocation of limited resources with the application of evidence-based screening; (3) seamless and appropriate care for mothers and their child at high risk of dental caries

Official Title
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Reducing Oral Health Disparity Through Outreach, Evidenced-Based Care, Global Budgeting and the Alternative Quality Contract

Conditions
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Dental Caries

Intervention / Treatment
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* Other: PREDICT


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Children less than 21 years old and women who are pregnant or up to 2 months-post-partum. Enrollment in Medicaid and assigned by Oregon Health Authority to receive dental care from Advantage Dental Plan. Home address is located in the selected counties. Exclusion Criteria: None

Ages Eligible for Study
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Maximum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| PREDICT<br>Delivery system changes where a team of dental providers (dentists, dental hygienists, case managers, community outreach workers and others) within Advantage Dental Services, LLC provide evidence-based screening, risk assessment and primary and secondary preventive care in non-conventional community settings (WIC, Head Start and similar settings) and seamless, timely and appropriate evidence-based care in dental clinics. Payment plan model based on global budgeting and Alternative Quality Contract (pay-for-performance) for dental providers within Advantage Dental Services, LLC (Advantage) with the goal of incentivizing implementation of delivery system changes aimed at reducing disparities in dental care utilization and oral health for low-income mothers and children.. | Other: PREDICT<br>* Allied dental personnel provide screening and preventive services in community settings and case managers serve as patient navigators to arrange referrals of children who need dentist services. The intervention is paired with a compensation system for high performance (pay-for-performance) with efficient performance monitoring. PREDICT focuses on: 1) identifying eligible children and gaining caregiver consent for services in community settings (e.g., schools); 2) providing risk-based preventive and caries stabilization services efficiently at these settings; 3) providing curative care in dental clinics; and 4) incentivizing local delivery teams to meet performance benchmarks.<br>|
| Control<br>Usual care | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Untreated dental caries | Percentage of participants with untreated dental caries | 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Consumer Satisfaction | Scores on the Dental Satisfaction Questionnaire | 2 years | 
| Dental care utilization | Percentage of participants 0-21 years of age and pregnant women who received a dental service | 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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managed healthcare, child, dental care