The Centers for Medicare & Medicaid Services is rapidly shifting to a cost-based reimbursement system. This is occurring first in medical programs, but it will eventually affect oral health programs. It is likely that future reimbursement will be based, at least in part, on how your program scores on quality metrics. The Uniform Data System sealant metrics is the beginning of this process. Health centers that understand how to use metrics to move their programs to improve quality will likely be the most successful.