Improving Service Provider Performance and Patient Outcomes

The Challenge

DentaQuest was already using analytics to assess the performance of Medicaid Dental providers. The existing models were developed to ensure long-term savings for the program by ensuring patients received the highest quality care for the lowest cost. However, they wanted to create a single simplified risk score that would provide a 360 degree view for each service provider.

The Solution

The approach for the outcomes model required distilling the results into a single risk score that encompassed the three dimensions of Outcome, Quality, and Utilization Intensity to provide a 360-degree view of each dental service provider. The solution developed by Elder Research combined the three dimensions. The Utilization Intensity score is represented by bubble size (a larger bubble represents a lower score).

Outcomes, DQA & UI Models Graphic 1

Results

The outcomes model provided quality information for specific procedures over time and enabled DentaQuest to reduce the amount paid per patient by 25% and increase revenue by more than one dollar per patient per month.

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