Section 2. Key Principles

Key Practice Parameters for Sustainability

There are four interrelated economic determinants on which a safety net dental clinic should focus. These determinants produce the outcomes that drive the clinic.

Factors that should be considered in driving these improvements include:

• Appropriate fee schedule (should never be below Medicaid; should be in the 80th percentile or above of prevailing fee schedules in the area).
• Appropriate level of staffing that maximizes the potential for productivity.
• Optimal and effective use of an electronic dental record that easily collects the data needed for billing and reporting.
• Well-designed and uniformly enforced broken-appointment policy (broken appointments should not run the schedule).
• Emergency/walk-in policy compatible with the appointment system (emergencies should not run the appointment book).
• Efficient system for patient registration/eligibility documentation and updating.
• Appointment system that allows multiple procedures (e.g., quadrant dentistry) to be done when appropriate.
• Patient satisfaction.
• Billing success (95 percent of expected collections).
• Quality assurance and quality improvement activities.

Key practice parameters for sustainability include:

• Effective recruitment.
• Pay, benefits, and working conditions that promote staff retention.
• Written policies and procedures that support the efficient provision of oral health care services and are adhered to.
• Ongoing, prospective professional peer review.
• Staff accountability for both the quality of their work and the revenue they produce.
• Effective communication among staff and between the oral health staff and the clinic’s administration.
• Leadership of the oral health team.