1. The Dental Quality Alliance (DQA) Overview and Work of the DQA

4. http://www. washingtonpost

7. Health Outcomes
Source: County Health Rankings

8. Pediatrics 2008;121;337-344 Kandyce Larson, Shirley A. Russ, James J
Pediatrics 2008;121; Kandyce Larson, Shirley A. Russ, James J. Crall and Neal Halfon Influence of Multiple Social Risks on Children's Health

9. December 27, 2016 US Spending on Personal Health Care and Public Health, Joseph L. Dieleman, PhD1; et al JAMA. 2016;316(24): doi: /jama

10. Better Healthcare/ Healthy Population Self-motivated improvement
Forced improvement
Accountability
Transparency

11. “Quality Innovators Spotlight”
Coming Soon!
“Quality Innovators Spotlight”

12. QC? QI? Better Healthcare/ Healthy Population
Self-motivated improvement
Forced improvement
Accountability
Transparency
QC? QI?

13. DQA Administrative Claims Based Program and Plan Level Pediatric Measures
Measure Name
Measure Domain
Evaluating Access and Utilization
Utilization of Services
Access/Process
Preventive Services for Children at Elevated Caries Risk
Related Health Care Delivery: Use of Services
Treatment Services
Evaluating Quality of Care
Oral Evaluation
Process
Topical Fluoride for Children at Elevated Caries Risk
Sealants for 6–9 Year-Old Children at Elevated Caries Risk 
Sealants for 10–14 Year-Old Children at Elevated Caries Risk 
Care Continuity
Usual Source of Services
Ambulatory Care Sensitive Emergency Department Visits for Dental Caries in Children
Outcome
Follow-Up after Emergency Department Visit by Children for Dental Caries
Evaluating Cost and Efficiency
Per Member Per Month Cost of Clinical Services
Related Health Care Delivery: Efficiency and Cost
To date, DQA has developed a set of 12 pediatric and 2 adult claims administrative program and plan level dental quality measures. The pediatric set targets the goal of addressing Prevention and Disease Management for Dental Caries in Children, with emphasis on utilization, cost, and quality of dental services for children enrolled in public (Medicaid, CHIP) and private (commercial) insurance programs. These measures are specified for reporting at program and plan level.

14. DQA Administrative Claims Based Program and Plan Level Adult Measures
Measure Name
Measure Domain
Evaluating Access and Utilization
Periodontal Evaluation in Adults with Periodontitis
Related Health Care Delivery: Use of Services
Evaluating Quality of Care
Ongoing Care in Adults with Periodontitis
Process
This slide depicts the two adult measures developed by the DQA.

15. 2015: Medicaid Use of DQA Measures

16. Projects under consideration
Emergency department visits for dental related reasons (adults)
Follow up to the emergency department visits (adults)
Oral evaluation in Adults Diagnosed with Diabetes
Caries Risk Documentation in children
DQA has several measures under consideration for testing in amongst these are the ones related to ED visits and oral evaluation in diabetics amongst adults and caries risk documentation amongst children.

17. Measured Entity
Reported By
Population
Data source
DQA Standard
Program/ Plan
All enrollees
Payer Administrative Database (Claims/Eligibility)
All enrollees with a dental exam D1
Practice
All enrollees receiving exams from a specific practice D2
All receiving exams from the practice
Practice management billing data D3
All patients receiving exams from the practice
All patient record data including history, findings and diagnoses

18. The Strategy That Will Fix Health Care. by Michael E
The Strategy That Will Fix Health Care. by Michael E. Porter and Thomas H. Lee, MD

19. “In measuring quality of care, providers tend to focus on only what they directly control or easily measured clinical indicators. However, measuring the full set of outcomes that matter to patients by condition is essential in meeting their needs.” – M. Porter

20. What is Quality?
What is oral health?
Better vs best

21. Global Budgets? P4P Health? P4P Healthcare?
The Strategy That Will Fix Health Care. by Michael E. Porter and Thomas H. Lee, MD

23. The Future: “Did we make the population healthy”
Patient reported oral health outcomes/ QOL
Population health state
Patient experience
Patient engagement
Clinical care indicators
Functional Status
Disease Status
Risk Status
Better vs best

26. A measure is a tool to improve
Great job with sick
Are you good keeping healthy
Compete for payment
Compete for reputation

27. E. M. Rogers in 1962 http://sphweb. bumc. bu

28. It’s time to spread the message!

29. THANK YOU! “Best is an endpoint. Better is a Quest”
-- Northwestern Memorial Hospital
Better versus best

30. Oral Health Status 42% 30% 24% 33% 27% 25% 37% 24% 18% 35% 21% 17% 30%
16%
26%
15%
17%
ADA Health Policy Institute. Oral Health and Well-Being in the United States