1
00:00:04,890 --> 00:00:06,380
This is the Becker's Healthcare Podcast,

2
00:00:06,450 --> 00:00:08,100
created by the team of
Becker's Healthcare,

3
00:00:08,260 --> 00:00:11,300
a multimedia company devoted to
the people who power us healthcare.

4
00:00:11,570 --> 00:00:15,540
Four new 15 minute episodes are released
daily containing industry news analysis

5
00:00:15,540 --> 00:00:16,340
and thought leadership.

6
00:00:16,340 --> 00:00:20,380
From powerful healthcare decision makers
Support our show by leaving it a five

7
00:00:20,380 --> 00:00:23,660
star rating and review on Apple
Podcast or other platforms you use.

8
00:00:23,810 --> 00:00:26,900
It's a chance to tell us what you like
about the show and act on your feedback.

9
00:00:26,920 --> 00:00:28,860
Thanks for listening.
Now here's the episode.

10
00:00:31,050 --> 00:00:33,820
This is Hat Dental podcast.

11
00:00:34,640 --> 00:00:38,290
I'm thrilled to be joined
today by Winter Jordan,

12
00:00:38,560 --> 00:00:43,050
president and c e o of Care, quest
Institute for Oral Health in c,

13
00:00:43,900 --> 00:00:47,290
chief Health Equity Officer of Care,
quest Institute for Oral Health,

14
00:00:48,380 --> 00:00:51,040
Maisha Caz. Thank you both
so much for being here today.

15
00:00:51,750 --> 00:00:53,050
So starting with Maisha,

16
00:00:53,060 --> 00:00:55,690
could you introduce yourself and
tell us a bit about your background?

17
00:00:56,740 --> 00:01:01,550
Sure. Um, so my name is Maisha Minter
Jordan. I'm a physician by training.

18
00:01:01,650 --> 00:01:04,030
I'm an internist. Um, and as you stated,

19
00:01:04,210 --> 00:01:07,390
I'm the president and c e o of Care
Quest Institute for Oral Health.

20
00:01:08,000 --> 00:01:09,470
Prior to my taking on this role,

21
00:01:09,870 --> 00:01:13,750
I led a community health center
located in Roxbury, Massachusetts,

22
00:01:14,380 --> 00:01:17,430
serving underserved and
marginalized populations.

23
00:01:18,050 --> 00:01:22,070
So I come to this work with the lens
of, um, really being focused on equity,

24
00:01:22,120 --> 00:01:25,270
being focused on how we think about
healthcare from an integrated,

25
00:01:25,670 --> 00:01:30,510
holistic framework, and also wanting to
make sure that as we talk about health,

26
00:01:30,510 --> 00:01:34,710
that we are inclusive of the patient's
whole body, which includes oral health,

27
00:01:35,170 --> 00:01:40,030
and that we understand the connectedness
between oral health and so many chronic

28
00:01:40,150 --> 00:01:44,950
diseases that impact both
Americans and and globally. Uh,

29
00:01:45,010 --> 00:01:49,070
and I'm excited to be able to join this
conversation today because I think it's

30
00:01:49,110 --> 00:01:54,110
a necessary one that providers
and patients need to focus in

31
00:01:54,110 --> 00:01:56,550
on and as well as policy makers, um,

32
00:01:56,650 --> 00:02:01,590
as we look to improve healthcare outcomes
and also reduce health healthcare

33
00:02:01,640 --> 00:02:02,473
costs.

34
00:02:03,050 --> 00:02:05,100
Fantastic. Thank you, Kaz.

35
00:02:05,790 --> 00:02:07,760
Yeah, thank you. Uh, my name is Kaz Raffi.

36
00:02:07,760 --> 00:02:11,040
I'm the Chief Health Equity Officer
here at Care Quest Institute for Rural

37
00:02:11,040 --> 00:02:16,000
Health. Uh, I am a dentist
by training and, uh,

38
00:02:16,130 --> 00:02:20,200
prior to this role, uh, where I,
as a Chief Health Equity officer,

39
00:02:20,200 --> 00:02:24,720
where I oversee our philanthropy as well
as our health transformation side of

40
00:02:24,720 --> 00:02:29,160
the house, where we have programmatic
initiatives around value-based care

41
00:02:29,910 --> 00:02:34,400
outcome, qualities of care, which are
inclusive of that integration piece.

42
00:02:34,980 --> 00:02:36,720
But prior to this role,

43
00:02:36,920 --> 00:02:39,680
I was with the state of Oregon
as a state dental director, and,

44
00:02:39,820 --> 00:02:43,680
and I love to tie into what Maisha
just mentioned, and that is the,

45
00:02:43,680 --> 00:02:47,160
the policy piece and how
medical, dental integration, uh,

46
00:02:47,260 --> 00:02:51,240
can be facilitated and, and,
and sort of catapulted, uh,

47
00:02:51,310 --> 00:02:54,760
when the policies are right. And that's
one of the things that I focus on,

48
00:02:54,760 --> 00:02:55,593
on my past role.

49
00:02:56,650 --> 00:03:00,370
Fantastic. Thank you.
So my first question is,

50
00:03:00,520 --> 00:03:04,930
what is the connection between oral
health and overall health? Tess,

51
00:03:04,930 --> 00:03:06,130
could you kick us off with that one?

52
00:03:06,680 --> 00:03:10,530
Yeah, thank you. Um, well, they're
literally and figuratively connected. I,

53
00:03:10,650 --> 00:03:13,450
I think a lot of us that have
been in this clinical space, we,

54
00:03:13,460 --> 00:03:18,010
we've seen this firsthand, you know,
through seeing our, our patients and,

55
00:03:18,150 --> 00:03:21,290
and if you're examining someone's
mouth, they, you know, we,

56
00:03:21,310 --> 00:03:25,970
we start literally by a review
of their medical history. And,

57
00:03:25,970 --> 00:03:28,290
and while this is really an
important question that you asked,

58
00:03:28,510 --> 00:03:32,370
it really goes to show the challenge
we're facing because we get this a lot.

59
00:03:32,910 --> 00:03:37,810
So oral health is health. Um,
more and more the research and,

60
00:03:37,830 --> 00:03:40,570
and the data, a lot of it coming
out of Care Quest Institute,

61
00:03:40,750 --> 00:03:45,400
our own work through our analytics
and data insight work has

62
00:03:45,650 --> 00:03:50,120
shown this inextricable connection. Uh,
but really this past decade has been,

63
00:03:50,380 --> 00:03:54,640
has shed a big light onto the connections
and linkage between oral health and

64
00:03:54,800 --> 00:03:59,520
overall health through gum
disease, tooth decay, oral cancer,

65
00:03:59,620 --> 00:04:01,920
and other health connections
that are really, um,

66
00:04:02,420 --> 00:04:06,600
tie into broader health conditions
outside of the mouth. Um,

67
00:04:06,980 --> 00:04:11,720
we have evidence that dementia,
pregnancy, preterm pregnancy, uh,

68
00:04:11,830 --> 00:04:15,800
arthritis, uh, diabetes,
um, are all connected.

69
00:04:16,100 --> 00:04:20,200
And really an oral health is, is one
of the ways that you can measure,

70
00:04:20,980 --> 00:04:25,400
uh, the overall health of an
individual. But, but I, I,

71
00:04:25,560 --> 00:04:27,400
I challenge all of us, if you will, to,

72
00:04:27,400 --> 00:04:31,960
to think of it as not this other
separate piece if you'll, but,

73
00:04:32,060 --> 00:04:36,920
but part of an overall physical
health evaluation in the con

74
00:04:37,240 --> 00:04:38,073
consideration.

75
00:04:39,240 --> 00:04:42,520
Interesting. Thank you. Maisha, do
you have any additional thoughts here?

76
00:04:44,220 --> 00:04:45,240
Yes. Um, I mean,

77
00:04:45,340 --> 00:04:49,320
as a physician and as one who led a
community health center that had both a

78
00:04:49,320 --> 00:04:53,040
dental clinic as well as
primary care, primary clinic,

79
00:04:53,040 --> 00:04:57,680
I saw this quite often in terms of the
correlation between oral health and

80
00:04:57,680 --> 00:04:58,640
chronic diseases.

81
00:04:59,100 --> 00:05:02,800
We know that poor oral health has a
direct link to heart disease, diabetes,

82
00:05:03,280 --> 00:05:08,280
dementia, hypertension, asthma, um, as
well as can impact the prenatal state.

83
00:05:08,540 --> 00:05:10,320
And then we find that that also happens,

84
00:05:10,680 --> 00:05:13,720
particularly in underserved
and marginalized populations,

85
00:05:13,750 --> 00:05:17,720
that poor oral health can
lead to, um, poor morbidity,

86
00:05:17,960 --> 00:05:19,360
maternal morbidity and mortality.

87
00:05:20,180 --> 00:05:23,880
We also know that dental disease can
also threaten a family's financial

88
00:05:24,080 --> 00:05:27,600
stability. So when we think about
other factors that influence health,

89
00:05:27,900 --> 00:05:31,720
we know that, uh, poor oral health
can also contribute to that.

90
00:05:31,820 --> 00:05:33,680
So these socioeconomic factors,

91
00:05:34,380 --> 00:05:38,560
so part of what we want to make sure
at Care Quest Institute is that we are

92
00:05:38,560 --> 00:05:42,800
supporting and incentivizing medical
and dental providers to prioritize whole

93
00:05:42,800 --> 00:05:45,680
person integrated care. And as Cas said,

94
00:05:45,700 --> 00:05:50,120
for us to be thinking about health
holistically inclusive of oral health,

95
00:05:50,120 --> 00:05:54,240
inclusive of behavioral health.
And, and I, I, this for me, um,

96
00:05:54,360 --> 00:05:58,020
hearkens back to the days when
behavioral health was siloed from overall

97
00:05:58,020 --> 00:06:01,120
healthcare and how much further
we've come. I see, um, many,

98
00:06:01,120 --> 00:06:05,840
many parallels between oral health
and primary care or overall health,

99
00:06:06,180 --> 00:06:07,280
um, in that being as well.

100
00:06:09,130 --> 00:06:12,130
Interesting. And Maisha, you
just kind of brought this up.

101
00:06:12,960 --> 00:06:16,980
Why is oral health so siloed
from the rest of healthcare?

102
00:06:18,160 --> 00:06:22,060
You know, it's really interesting
as I have become more and more, um,

103
00:06:22,980 --> 00:06:27,180
invested in understanding that very
question, it really is historical.

104
00:06:27,480 --> 00:06:29,020
The notion of dentistry as a,

105
00:06:29,020 --> 00:06:33,140
as a field that's separate from medicine
is a historical phenomenon that really

106
00:06:33,140 --> 00:06:34,660
started when, um,

107
00:06:34,660 --> 00:06:39,380
there were practitioners who seemed
to be more of a tradesman, um, uh,

108
00:06:39,380 --> 00:06:44,140
focused on pulling teeth. Um, right
now we know that oral healthcare has,

109
00:06:44,240 --> 00:06:47,300
has developed, um, over time to be a,

110
00:06:47,460 --> 00:06:51,180
a significant impact and significant
correlation to overall health.

111
00:06:51,760 --> 00:06:54,420
And so we really want to
move past that, those,

112
00:06:54,470 --> 00:06:57,980
those historical phenomenon
that led to it being siloed.

113
00:06:58,400 --> 00:07:02,300
And we also know that healthcare in
general has been somewhat past work,

114
00:07:02,320 --> 00:07:04,060
as I mentioned, behavioral health earlier.

115
00:07:04,680 --> 00:07:09,020
And it isn't a system that currently is
designed or well designed to achieve the

116
00:07:09,020 --> 00:07:10,260
best outcomes for patients.

117
00:07:10,800 --> 00:07:14,780
And we know that integration is something
that needs to happen across the board.

118
00:07:15,240 --> 00:07:20,220
Um, and it's clear when you consider
that 68 million Americans lack dental

119
00:07:20,660 --> 00:07:24,420
coverage and Medicare and some Medicaid
programs don't provide oral health

120
00:07:24,700 --> 00:07:26,420
benefits to seniors or low income adults.

121
00:07:26,960 --> 00:07:30,100
We know that the impact of QA continuing,

122
00:07:30,120 --> 00:07:34,940
the siloing of the different aspects
of one's healthcare are only harming

123
00:07:34,940 --> 00:07:39,500
our patients and only harming
Americans increasing costs and,

124
00:07:39,640 --> 00:07:41,900
and really not improving patient outcomes.

125
00:07:44,160 --> 00:07:46,080
Interesting. Kass, I'd love
to hear that too as well.

126
00:07:46,710 --> 00:07:50,820
Yeah, Maisha pointed out to probably
the, the, the biggest indicator,

127
00:07:50,830 --> 00:07:55,620
which is the historical fracture,
if you will, in, in the training of,

128
00:07:55,800 --> 00:07:58,260
of physicians versus dentists. But, uh,

129
00:07:58,260 --> 00:08:01,140
really the reality is that
what history is critical.

130
00:08:01,200 --> 00:08:05,660
It shouldn't define how we approach
oral healthcare currently. A again,

131
00:08:06,380 --> 00:08:11,260
reemphasizing the policy piece. We know
that the, it, it, when it comes to, uh,

132
00:08:11,360 --> 00:08:15,740
our own healthcare policy in the us
there's a disconnect of mouth between and

133
00:08:15,740 --> 00:08:17,940
the body. Uh, so that perpetuates it.

134
00:08:18,090 --> 00:08:22,060
Oral healthcare is also not really seen
as something that's essential as an

135
00:08:22,060 --> 00:08:26,420
essential healthcare service. And this
is a fight that we're sort of, you know,

136
00:08:26,530 --> 00:08:30,900
engaged in when it comes to, uh,
Medicare, Medicaid, adult dental benefits.

137
00:08:30,930 --> 00:08:34,340
It's, it's this argument
that we constantly have to
make. And so it's critical,

138
00:08:34,450 --> 00:08:37,100
it's important. There is an
economic burden, if you will,

139
00:08:37,680 --> 00:08:42,060
on those minoritized and marginalized
communities that's disproportionate as

140
00:08:42,260 --> 00:08:45,180
compared to those who can in fact, uh,

141
00:08:45,200 --> 00:08:50,060
engage private payers and private sources
for their insurance benefits and their

142
00:08:50,300 --> 00:08:50,720
coverage.

143
00:08:50,720 --> 00:08:55,440
So now we have a fracturing and
separation of education and training.

144
00:08:55,660 --> 00:08:58,160
We also have the policy landscape
that treats them separately.

145
00:08:58,660 --> 00:09:02,800
We have the delivery that are, that are
done in, in completely different, uh,

146
00:09:02,900 --> 00:09:05,640
spaces for the most
part. Uh, and you know,

147
00:09:05,640 --> 00:09:08,200
this is a great conversation around
talking about the value of medical,

148
00:09:08,200 --> 00:09:12,080
dental integration. And, and lastly,
probably most importantly, again,

149
00:09:12,100 --> 00:09:16,720
as I mentioned, is who pays for
this and how is that payment, um,

150
00:09:16,870 --> 00:09:21,800
allocated? Um, and, and so those are
all the constraints against this, uh,

151
00:09:22,100 --> 00:09:26,200
our efforts wanting to, to create
integration between medical and dental.

152
00:09:27,590 --> 00:09:29,820
Thank you. And you sort
of dived into this, um,

153
00:09:30,290 --> 00:09:34,100
just now I'm curious as
to, in a perfect world,

154
00:09:34,290 --> 00:09:37,860
what does medical dental
integration actually look like?

155
00:09:39,000 --> 00:09:42,690
Well, to me at least, it doesn't
have to have a a, a particular look.

156
00:09:42,720 --> 00:09:45,050
It's not prescriptive as, you know,

157
00:09:45,050 --> 00:09:49,110
it needs to account for
context limitations such as,

158
00:09:49,810 --> 00:09:54,430
you know, physical space, availability
of providers, some of that reimbursement,

159
00:09:54,690 --> 00:09:59,430
uh, landscape that I talked about.
But in its absolute ideal form,

160
00:09:59,490 --> 00:10:02,350
we used to call it the magic
wand, if you will. It could be,

161
00:10:02,850 --> 00:10:06,830
it could be fully co-located,
uh, seamlessly in a,

162
00:10:06,980 --> 00:10:11,950
like in a interconnected on an electronic
health record platform that's suitable

163
00:10:12,010 --> 00:10:14,830
for dental and medical
and behavioral needs.

164
00:10:15,490 --> 00:10:17,190
But probably most importantly to me,

165
00:10:17,530 --> 00:10:22,110
it are clinicians and providers who
understand the why for integration,

166
00:10:22,690 --> 00:10:27,470
but are also incentivized properly to
practice in that sort of setting. So the,

167
00:10:27,570 --> 00:10:30,790
the, the, the, the physical
layout, if you will,

168
00:10:30,890 --> 00:10:33,270
the look of it is critical.

169
00:10:33,360 --> 00:10:36,390
Practicing under the same roof
creates those efficiencies,

170
00:10:36,810 --> 00:10:40,230
but the clinicians and the providers
need to understand the why and,

171
00:10:40,410 --> 00:10:42,150
and really be engaged and immersed in it.

172
00:10:43,410 --> 00:10:45,040
Thank you. Maisha, any thoughts here?

173
00:10:46,360 --> 00:10:50,620
Yes. You know, I, I harken back to my
experience in the community health center,

174
00:10:50,800 --> 00:10:55,260
and one of the things that we did
actively was in our dental clinic,

175
00:10:55,400 --> 00:10:59,860
we ran a list of all of our patients
with diabetes because we understood that

176
00:11:00,220 --> 00:11:04,700
patients with diabetes have a higher risk
of uncontrolled diabetes if they have

177
00:11:04,890 --> 00:11:05,723
poor oral health.

178
00:11:06,360 --> 00:11:10,180
So these are small things that
have a significant impact.

179
00:11:10,200 --> 00:11:14,900
And we also knew by getting those patients
into care within the dental office,

180
00:11:15,040 --> 00:11:19,700
we could also use that opportunity
to educate and check in on their

181
00:11:19,980 --> 00:11:23,940
diabetes status. Similarly,
within our OB G Y N clinic,

182
00:11:24,080 --> 00:11:26,380
we ran a centering pregnancy program,

183
00:11:26,920 --> 00:11:30,140
and within that program we
had pregnant mothers, um,

184
00:11:30,250 --> 00:11:32,300
make appointments to go
to our dental clinic.

185
00:11:32,480 --> 00:11:37,340
We also had our dentists come into
those prenatal group visits and talk

186
00:11:37,340 --> 00:11:41,700
about the importance of oral healthcare.
So it's this holistic approach.

187
00:11:41,730 --> 00:11:46,060
When we think about the integration we
want as patients to understand that all

188
00:11:46,060 --> 00:11:49,860
of the providers that treat us,
that touch us understand our body.

189
00:11:49,860 --> 00:11:54,000
They understand which medications are
being provided by other providers in the

190
00:11:54,000 --> 00:11:56,600
interaction between those. They want,

191
00:11:56,620 --> 00:12:01,040
we want our providers to be speaking with
one another about our care and to have

192
00:12:01,060 --> 00:12:04,520
us at the center. So for me,
when I think about integration,

193
00:12:04,550 --> 00:12:08,920
it's holding the patient at the center
understanding that all of their, their,

194
00:12:09,100 --> 00:12:11,760
the components of their body
interact with one another,

195
00:12:12,220 --> 00:12:16,520
and that we are providing a patient
care plan that empowers the patient in

196
00:12:16,520 --> 00:12:17,480
partnership with the patient,

197
00:12:17,540 --> 00:12:19,920
but takes into account all
aspects of their health.

198
00:12:21,520 --> 00:12:21,880
Yeah,

199
00:12:21,880 --> 00:12:25,330
that definitely sounds like there's a
lot of benefits to the patients there.

200
00:12:25,760 --> 00:12:28,210
When thinking about medical
dental integration and,

201
00:12:28,230 --> 00:12:31,730
and the whole body and its
connection to oral health health,

202
00:12:31,750 --> 00:12:36,050
I'm curious how does medical dental
integration benefit the provider as well?

203
00:12:36,550 --> 00:12:37,650
Maisha, could we start with you?

204
00:12:39,250 --> 00:12:39,680
Sure.

205
00:12:39,680 --> 00:12:44,460
So our research from Care Institute for
Oral Health indicates that providers

206
00:12:44,820 --> 00:12:46,500
actually want more medical integration,

207
00:12:46,500 --> 00:12:50,300
that they just don't often have the tools
or support that they need to implement

208
00:12:50,300 --> 00:12:51,740
it. Um, for example,

209
00:12:51,870 --> 00:12:55,500
while only one third of oral
health providers say they
currently screen patients

210
00:12:55,500 --> 00:12:56,333
for diabetes,

211
00:12:56,850 --> 00:13:00,060
more than half would be more willing
to screen if they had better tools to

212
00:13:00,340 --> 00:13:01,740
identify those at risk for diabetes.

213
00:13:02,520 --> 00:13:06,180
CAS can certainly speak to some of the
programs that we run nationally that,

214
00:13:06,370 --> 00:13:09,060
that focus on integration
and focus on training,

215
00:13:09,640 --> 00:13:13,100
but I can tell you that
providers, um, being one myself,

216
00:13:13,400 --> 00:13:16,780
our goal is to make sure that we're
providing the best care for our patients.

217
00:13:17,320 --> 00:13:20,740
So if we have adequate training
tools, resources, and support,

218
00:13:21,130 --> 00:13:22,180
then that's what we will do.

219
00:13:22,720 --> 00:13:27,260
And so by elevating the conversation to
both the medical provider community as

220
00:13:27,260 --> 00:13:28,940
well as the oral health community,

221
00:13:29,480 --> 00:13:33,300
our goal at Care Quest Institute
is to promote those conversations,

222
00:13:33,370 --> 00:13:38,020
that discourse to understand how do we
then continue to advocate for policy that

223
00:13:38,020 --> 00:13:39,020
supports providers,

224
00:13:39,320 --> 00:13:44,060
and then also how do we engage consumers
so that they're asking the same of

225
00:13:44,060 --> 00:13:48,300
their providers that they're asking for
integrated in holistic healthcare, um,

226
00:13:48,400 --> 00:13:52,140
as they come to understand the importance
of oral health and its impact on the

227
00:13:52,140 --> 00:13:53,300
body. <inaudible>,

228
00:13:53,330 --> 00:13:55,780
I'll turn it to you to talk about some
of the programs that we're running

229
00:13:55,780 --> 00:13:56,613
nationally.

230
00:13:57,050 --> 00:14:00,140
Yeah, thank you so much. Um,
so one of the things that I,

231
00:14:00,140 --> 00:14:04,660
one of the programs that, that,
uh, we, we happen to, to, uh,

232
00:14:05,260 --> 00:14:08,660
initiate through our health transformation
is medical oral expanding care.

233
00:14:08,690 --> 00:14:11,380
This is really a breakthrough
serious collaborative model.

234
00:14:11,880 --> 00:14:13,180
We work within communities,

235
00:14:13,180 --> 00:14:17,980
we establish an interprofessional oral
health network, uh, and we really, uh,

236
00:14:17,980 --> 00:14:19,780
our, our focus is, uh,

237
00:14:19,780 --> 00:14:22,740
first on making sure that the
medical practices have the develop,

238
00:14:23,010 --> 00:14:24,580
have the skills, uh,

239
00:14:24,680 --> 00:14:28,580
and are adopting the processes that are
needed to integrate oral health services

240
00:14:28,640 --> 00:14:32,340
within their existing workflows.
So that's really intentional.

241
00:14:32,640 --> 00:14:36,820
The medical practices then work to
really implement this IT technology

242
00:14:36,820 --> 00:14:37,300
solutions,

243
00:14:37,300 --> 00:14:41,660
which allows for electronic referral
communication to dental practices.

244
00:14:42,320 --> 00:14:46,340
So really we focus our work around
strengthening provider communications,

245
00:14:46,340 --> 00:14:50,980
which is really, really important in the
midst of one of our initiative in Ohio.

246
00:14:51,180 --> 00:14:54,840
And then, and the number of wins
the quanti quantifiable wins and,

247
00:14:54,860 --> 00:14:57,960
and the impact are just
really astonishing. Uh,

248
00:14:58,020 --> 00:15:01,280
our state-based partners in Ohio have
been able to work with local dental

249
00:15:01,560 --> 00:15:02,260
providers, the,

250
00:15:02,260 --> 00:15:06,600
and organized dentistry to create this
referral relationships so the patient are

251
00:15:06,720 --> 00:15:11,520
actually seeing in primary care practices
and these can actually be scaled. Um,

252
00:15:11,780 --> 00:15:15,080
and so they're all rooted
around strengthening those
provider communications,

253
00:15:15,380 --> 00:15:17,000
um, that Maisha was talking about.

254
00:15:18,660 --> 00:15:19,493
Thank you both.

255
00:15:20,360 --> 00:15:23,980
Are there any cost savings to
medical dental integration?

256
00:15:25,270 --> 00:15:27,570
Uh, we begin with you. Yeah.

257
00:15:27,830 --> 00:15:32,290
So, so dovetailing from that,
that provider communication,

258
00:15:32,370 --> 00:15:34,370
I think when systems talk and connect,

259
00:15:34,370 --> 00:15:36,690
there is an inherent
benefit in terms of savings,

260
00:15:36,960 --> 00:15:39,530
savings from reduced errors,

261
00:15:39,590 --> 00:15:44,250
proper diagnostic imaging and labs that
can be shared instead of duplicated,

262
00:15:44,910 --> 00:15:45,130
uh,

263
00:15:45,130 --> 00:15:48,690
institutes of medicine and approximate
really the cost of medical errors to be

264
00:15:48,690 --> 00:15:51,690
around anywhere between
18 to 30 billion annually.

265
00:15:51,690 --> 00:15:56,450
And this is medical demotion can actually
be a solution that can have economic

266
00:15:56,670 --> 00:16:01,210
impact in a, in a positive manner.
Um, and, and this loss, if you'll,

267
00:16:01,210 --> 00:16:05,170
the medical errors doesn't even capture
the cost of cost Implications of

268
00:16:06,010 --> 00:16:11,010
misdiagnoses is oral health cancer
screenings that go missed cost of days

269
00:16:11,390 --> 00:16:13,130
missed from work, uh,

270
00:16:13,130 --> 00:16:18,010
because of dental decay
cost of individuals who did
not get the right referral

271
00:16:18,110 --> 00:16:22,090
to their primary care providers because
we did not have the right setting to

272
00:16:22,090 --> 00:16:24,170
have the A one C testing done.

273
00:16:24,550 --> 00:16:28,490
So when you do implement these
systems in place, these efficiencies,

274
00:16:29,400 --> 00:16:34,210
cost savings are not just to the system,
but also to the individual as well,

275
00:16:34,380 --> 00:16:39,330
who's, who's most, uh, most impacted
by, by, um, by the high cost of care.

276
00:16:39,940 --> 00:16:43,070
Thank you. That's really unique
way of putting it. Maisha,

277
00:16:43,070 --> 00:16:44,310
do you have any hook ons here?

278
00:16:45,680 --> 00:16:47,380
Yes, I would say, um, we,

279
00:16:47,400 --> 00:16:51,980
we know that the C D C estimates that
integrating basic health screening into a

280
00:16:51,980 --> 00:16:56,820
dental setting could save the healthcare
system up to $100 million every year.

281
00:16:57,660 --> 00:16:59,500
Additionally, um, we know that um,

282
00:16:59,500 --> 00:17:03,580
many individuals seek care in the
emergency department for dental, um,

283
00:17:03,640 --> 00:17:06,300
for dental care because they
don't have a dental provider.

284
00:17:06,880 --> 00:17:10,180
So we know that up to $520 million, um,

285
00:17:10,210 --> 00:17:14,540
that of Medicare spend happens because
of dental emergency department visits.

286
00:17:15,200 --> 00:17:17,860
And so we know just in
addition to what Cass has said,

287
00:17:17,860 --> 00:17:21,820
that there are significant
savings that can happen, um,

288
00:17:22,130 --> 00:17:26,500
once we think more holistically about
care and hold the patient at the center.

289
00:17:28,390 --> 00:17:30,880
Thank you, Kass. I'm curious,

290
00:17:31,460 --> 00:17:35,160
how does medical dental
integration address health equity?

291
00:17:35,560 --> 00:17:40,400
I know you talked a lot about that, um,
earlier as well, but as a whole, um,

292
00:17:40,600 --> 00:17:42,040
thinking about health equity,

293
00:17:42,920 --> 00:17:46,100
how does medical dental
integration address that?

294
00:17:47,330 --> 00:17:48,790
So while not a silver.

295
00:17:48,880 --> 00:17:51,360
Bullet to addressing health inequities,

296
00:17:52,080 --> 00:17:56,600
a medical dental integration
is an important component
and part of the solution,

297
00:17:57,180 --> 00:17:57,700
uh,

298
00:17:57,700 --> 00:18:02,560
for one integrated models of care
that are co-located could result in

299
00:18:02,840 --> 00:18:05,920
physical health as well as behavioral
health issues and concerns being

300
00:18:07,080 --> 00:18:10,240
identified through a dental
provider or vice versa,

301
00:18:11,000 --> 00:18:15,560
followed by a seamless and successful
warm handoff to the appropriate

302
00:18:15,960 --> 00:18:17,240
providers for the next steps.

303
00:18:18,400 --> 00:18:23,140
And this could translate into closing
critical care gaps and improving

304
00:18:23,160 --> 00:18:27,940
health outcomes that are really long
impacted underserved communities.

305
00:18:29,670 --> 00:18:30,790
Additionally, um,

306
00:18:31,070 --> 00:18:34,950
I think medical dental integration
would ease transportation concerns for

307
00:18:35,190 --> 00:18:38,340
patients as it would allow for, you know,

308
00:18:38,520 --> 00:18:42,820
one stop provision of care and
reduction of the negative impact on

309
00:18:43,420 --> 00:18:47,510
patients employment through
missed work right away.

310
00:18:47,740 --> 00:18:52,350
This would create improved access
and remove the potential of having to

311
00:18:53,240 --> 00:18:57,830
prioritize healthcare concerns
of one part of patient's body

312
00:18:57,980 --> 00:18:59,830
over other parts of the patient's body.

313
00:19:00,390 --> 00:19:04,390
I also think that medical
dental integration can lead
to cost savings that were

314
00:19:04,390 --> 00:19:08,790
mentioned earlier through early
and preventative interventions,

315
00:19:09,450 --> 00:19:14,070
um, reduced medical errors and higher
patient and provider satisfaction,

316
00:19:14,560 --> 00:19:17,630
which are all components
of the quintuple aim.

317
00:19:19,080 --> 00:19:21,510
Thank you, Maisha. I'd love to
hear your thoughts here as well.

318
00:19:22,900 --> 00:19:25,960
Yes, I mean, just building
upon what CAS has said,

319
00:19:26,510 --> 00:19:30,560
part of what we know will happen with
medical or dental integration is an

320
00:19:30,800 --> 00:19:32,840
increase in access for
vulnerable populations.

321
00:19:33,580 --> 00:19:37,200
Recent data from Care Quest
Institute shows that, um,

322
00:19:37,200 --> 00:19:39,440
61% of black Americans,

323
00:19:39,450 --> 00:19:44,360
58% of Hispanic adults were less likely
to visit the dentist in the last year

324
00:19:44,390 --> 00:19:45,320
than white adults.

325
00:19:45,980 --> 00:19:50,280
We know that gum disease is almost 20%
more prevalent among Hispanic adults

326
00:19:50,780 --> 00:19:53,720
and black adults as compared
to non-Hispanic white adults.

327
00:19:54,340 --> 00:19:57,880
We also know that black and Hispanic
adults are more than twice as likely to

328
00:19:57,880 --> 00:20:01,440
report that they had never been to a
dentist as compared to white adults.

329
00:20:02,020 --> 00:20:03,960
So part of this is an access issue,

330
00:20:04,380 --> 00:20:09,080
and when you are tapping
into the medical visit to

331
00:20:09,250 --> 00:20:12,960
begin to then incorporate and, uh,

332
00:20:13,270 --> 00:20:16,080
provide access to the dental community,

333
00:20:16,180 --> 00:20:19,520
you are helping to provide
access for patients who you two,

334
00:20:19,680 --> 00:20:23,640
four have been marginalized and
have had reduced access, uh,

335
00:20:23,640 --> 00:20:27,120
resulting in the outcomes that
I stated. So part of what we're,

336
00:20:27,190 --> 00:20:31,480
what we're positing is that when
we address this issue around

337
00:20:31,590 --> 00:20:34,520
integration by creating a more
holistic approach to care,

338
00:20:34,580 --> 00:20:38,160
you have dental providers, you
have primary care providers,

339
00:20:38,670 --> 00:20:42,640
keeping the patient at the center
referring to one another, sharing data,

340
00:20:47,690 --> 00:20:51,400
treat the patient holistically,
um, as we all would want, um,

341
00:20:51,470 --> 00:20:53,320
when we encounter the medical system.

342
00:20:54,960 --> 00:20:57,010
Fantastic. Well, Maisha Ka,

343
00:20:57,140 --> 00:21:00,530
thank you so much for your fascinating
insights in this discussion today.

344
00:21:00,970 --> 00:21:03,810
I look forward to connecting with
you again in the future. Thank.

345
00:21:04,570 --> 00:21:07,250
You so much for the opportunity.
Thank you very much.

346
00:21:10,440 --> 00:21:13,690
It's so important for leaders at the
top of organizations to keep learning,

347
00:21:13,880 --> 00:21:15,530
stay sharp, grow their networks,

348
00:21:15,960 --> 00:21:19,130
help our audience better do this
in a more simplified, personalized,

349
00:21:19,150 --> 00:21:22,850
and meaningful way. Becker's
Healthcare has launched my B h c,

350
00:21:23,360 --> 00:21:26,650
it's your trusted Becker's healthcare
experience and more with content,

351
00:21:26,680 --> 00:21:28,890
connections, events and
learning opportunities.

352
00:21:29,600 --> 00:21:34,530
Join the community free of
charge@www.my dot becker's hospital

353
00:21:34,530 --> 00:21:36,410
review.com and we'll see you there.