Unit 1: Essential Elements
Unit 1: Essential Elements

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.

Economic Determinants Outcomes
  • Productivity
  • Revenue
  • Cost
  • Quality
  • Improved oral health status of the patient population served.
  • A financially viable delivery system

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.