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Open AccessArticle

Dental Practice Integration into Primary Care: A Microsimulation of Financial Implications for Practices

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Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA 02115, USA
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Office of Global and Community Health, Harvard School of Dental Medicine, Boston, MA 02115, USA
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Harvard Medical School, Boston, MA 02115, USA
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Department of Biomedical Informatics, Harvard Medical School, Boston, MA 02115, USA
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Center for Primary Care, Harvard Medical School, Boston, MA 02115, USA
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Research and Analytics, Collective Health, San Francisco, CA 94107, USA
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School of Public Health, Imperial College London, London SW7 2BU, UK
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(6), 2154; https://doi.org/10.3390/ijerph17062154
Received: 24 February 2020 / Revised: 20 March 2020 / Accepted: 22 March 2020 / Published: 24 March 2020
(This article belongs to the Special Issue Big Data in Dental Research and Oral Healthcare)
Given the widespread lack of access to dental care for many vulnerable Americans, there is a growing realization that integrating dental and primary care may provide comprehensive care. We sought to model the financial impact of integrating dental care provision into a primary care practice. A microsimulation model was used to estimate changes in net revenue per practice by simulating patient visits to a primary dental practice within primary care practices, utilizing national survey and un-identified claims data from a nationwide health insurance plan. The impact of potential changes in utilization rates and payer distributions and hiring additional staff was also evaluated. When dental care services were provided in the primary care setting, annual net revenue changes per practice were −$92,053 (95% CI: −93,054, −91,052) in the first year and $104,626 (95% CI: 103,315, 105,316) in subsequent years. Net revenue per annum after the first year of integration remained positive as long as the overall utilization rates decreased by less than 25%. In settings with a high proportion of publicly insured patients, the net revenue change decreased but was still positive. Integrating primary dental and primary care providers would be financially viable, but this viability depends on demands of dental utilization and payer distributions.
Keywords: integrated care, medical–dental integration, simulation model, dental research integrated care, medical–dental integration, simulation model, dental research
MDPI and ACS Style

Choi, S.E.; Simon, L.; Barrow, J.R.; Palmer, N.; Basu, S.; Phillips, R.S. Dental Practice Integration into Primary Care: A Microsimulation of Financial Implications for Practices. Int. J. Environ. Res. Public Health 2020, 17, 2154.

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