MEDICAL+DENTAL INTEGRATION - Oregon · 17-10-2017 · • Medical & Dental integrated care with focus on chronic conditions ... Practice Support, Northwest Permanente, Successful

MEDICAL+DENTAL INTEGRATIONORAL HEALTH WELLNESS MANAGEMENT

Presented by: Dr. Daniel PihlstromOctober 17, 2017

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TODAY’S AGENDA

• Medical & Dental integrated care with focus on chronic conditions• Kaiser Permanente’s oral health program description• Promoting wellness and measuring outcomes• Innovation and the future of medical/dental integration• Presenting new models of care at Kaiser Permanente

1 | MEDICAL + DENTAL INTEGRATION | October 17, 2017

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THE PRICE OF HEALTHCHRONIC DISEASE OUTCOMES AND COSTS

Type 2 diabetes-related costs $2,840 or 40.2%

Stroke-related costs $5,681 or 40.9%

Heart disease-related costs $1,090 or 10.7%

Pregnancy-related costs $2,433 or 73.7%


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5 | MEICAL + DENTAL INTEGRATION | October 17, 2017

PROFILE OF AN INTEGRATED MEMBER

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Diabetic population receiving dental care have lower costs per member per month (PMPM) than those NOT receiving dental care; after adjusting for patient characteristics.

Overall costs Savings

Diabetic population receiving dental care had $129 PMPM lower costs overall than those NOT receiving dental care

Inpatient Cost Savings

Diabetic population receiving dental care had $101 PMPM lower inpatient costs than those NOT receiving dental care

ED-Urgent Care Savings

Diabetic population receiving dental care had $13 PMPM lower ED/urgent costs than those NOT receiving dental care


MEASURING SUCCESS OF AN INTEGRATED MEMBERBdatt.4

Tobacco Cessation

Diabetes

Breast Cancer Screening

Cervical Cancer Screening

Colorectal Cancer Screening

ChildhoodImmunization

Screening & Well Child Visits

Blood Pressure Assessment

$3,400 medical savings per year for each employee that quits smoking – according to the CDC.

20%-25% smokers who enroll in a cessation program including medications will successfully quit.

5.7% of dental program assisted referral and nicotine replacement therapy product accepted

Wellness and Preventive Care

USING ORAL HEALTH PROVIDERS AS EXTENDERS OF PRIMARY CARE TO IMPROVE HEALTH OUTCOMES


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• Dental ranks 2nd out of 43 specialties in addressing medical care gaps (63.2% of dental visits receive a patient friendly handout*)

• Across 8 key HEDIS measures, Dental ranks in the top 4 specialties, and in two cases ranks number 1:

– Breast cancer screening

– Colorectal cancer screen

PATIENT SUPPORT TOOL

*10,556 patient friendly handouts out of 16,712 visits with a care gap opportunities in January 20177 | MEICAL + DENTAL INTEGRATION | October 17, 2017

USING ORAL HEALTH PROVIDERS AS EXTENDERS OF PRIMARY CARE TO IMPROVE HEALTH OUTCOMES

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Kaiser Permanente is Launching Oral Care Gap Closure in the North Service Area Medical Offices in 2017

Care Gap Reminders Include:• All diabetic patients that have not been

in for a dental visit in 15+ months • For children ages 1-4 that have not

had a dental appointment


USING MEDICAL HEALTH PROVIDERS AS EXTENDERS OF DENTAL CARE TO IMPROVE ORAL HEALTH OUTCOMES

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• This chart reflects PEBB members with a chronic medical condition* compared to total PEBB membership• The largest number of PEBB members with a chronic disease are in the Maintenance category (OHS-2) or have not been in for an

exam in 15 months or more (OHS-4)*Chronic Medical Conditions: Diabetes, Chronic Kidney Disease, Heart Failure, Hypertension, Asthma, Coronary Artery Disease, Prenatal, or Smoker.

CATEGORY AND DEFINITION PEBB KP DentalProgram

OHS-1 WELLNESS: Requires only 12-month exam/recall

5.9% 4.4%

OHS-2 MAINTENANCE: Moderate perio/caries risk, or preventive care gaps, or with stable perio condition

27.7% 26.7%

OHS-3 HIGH NEEDS: Requires treatment that if not addressed could cause pain within 12 months

17.8% 15.3%

OHS-4 UNKNOWN: Has not had exam in past 15 months (but had one previously)

31.3% 23.9%

OHS-N NEW: Has never accessed the dental program

17.3% 29.6%

PEBB September 2017

9 | MEICAL + DENTAL INTEGRATION | OCTOBER 13, 2017

STRATEGIES TO LEVERAGE CLINICAL OUTCOMES Oral Health Status and Chronic Disease

1251,127 816

1,302479

790

3,700

2,385

4,179

2,317

OHS-1Wellness

OHS-2Maintenance

OHS-3Needs

OHS-4Unknown

OHS-NNew

PEBB Members with a Chronic Medical Condition* PEBB

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KAISER PERMANENTE’S

CEDAR HILLS MODEL


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MDI Vision: Provide an

integrated medical and

dental experience that is

a new standard for high-

quality, convenient and

affordable health care.

Cedar Hills Dental and Medical Office Full service dental office with medical appointments

for minor injuries, illnesses and preventive services.

Convenient one-stop check-in for medical and dental

Unified system to identify care gaps in advance

Warm hand-off of the patient between dental & medical

KP HealthConnect Integrated Health Record

One single platform and supporting infrastructure for the KP EHR

Integration of appointing, billing and claims functions

View and cancel upcoming dental appointments

Scalable and flexible technology supporting growing membership, integrated facilities and new care delivery models (mobile, worksite, teledentistry, virtual dental home)


MEDICAL+DENTAL INTEGRATION (MDI)New ways we are providing care

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1. Member arrives for dental procedure2. Member has high blood pressure3. Stop Care4. Member must call to make a

medical appointment

5. Member takes time off from work and drives to medical office

6. Member receives primary care7. Member must call to make

another dental appointment

8. Member takes time off work again and drives to dental office

9. Member receives dental care

1. Member arrives for dental procedure2. Member has high blood pressure3. Stop Care4. Member receives primary care in the

same office5. Dental staff helps schedule member

another dental appointment

6. Member drives to dental office7. Member receives dental care

Dental Care CompleteWeek 8

THE ROAD TO DENTAL CARE IS SHORTER WITH KP DENTAL

Dental Care CompleteWeek 2

ONEKP

Care at Cedar Hills (Medical + Dental Office)

Care Outside Cedar Hills

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MDI

• Improved member satisfaction

• Improved brand valueService

• Care gap closure rate• Referral rate• Diagnosis refresh (Medicare)

Quality

• Utilization/services per appointment time

• Saved primary care visitsAffordability

Member Satisfaction (↑)

HEDIS Ratings (↑)

Time (↓) Productivity (↑)

MEDICAL/DENTAL INTEGRATION FUTURE MODEL OF CARE (Cedar Hills Location Pilot)

+


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Meeting our patients where and when they want care. Offering our patients on-demand options to connect with our high quality providers – by phone, email, or in-person.

NEW TECHNOLOGY• Kp.org (& mobile app)• E-mail your dentist• Teledentistry• Schedule appointments online• Text reminders

ALL-UNDER-ONE-ROOF• Medical-dental co-location• New care models• Medical-dental appt in one visit• Greater level of coordinated care

ORAL HEALTH MANAGER• Member after visit health report card• Medical assist in dental referrals• Dentist Panel Management Tool

Co-located Medical & Dental Clinics

Virtual Care

Robust Member Tools and Reminders

Supported

Self-Serve

Future

PRESENT & FUTURE STATE OF INTEGRATIONMembers’ Experience


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$

Kaiser Permanente Dental Innovation and Integration

Member satisfaction, care quality, overall wellness

Medical cost plan by managing members’ overall health


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Thank you for the opportunity to serve you and PEBB members.

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APPENDIXBdatt.4

REFERENCES

I. Kaiser Permanente Center for Health Research, Comparison of HEDIS Outcomes Among Dental/Medical vs. Medical Only Population (2013).

II. Practice Support, Northwest Permanente, Successful Opportunities Report, Visits between July 2014 and December 2014 — HEDIS Measures, accessed March 16, 2015.

III. Kaiser Permanente Northwest actuarial data (claims analyzed over a two-year period from 2011–2013. Savings based on 6,872 commercial and 2,767 Medicare members).

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Documents

MEDICAL+DENTAL INTEGRATION - Oregon · 17-10-2017 · • Medical & Dental integrated care with focus on chronic conditions ... Practice Support, Northwest Permanente, Successful