CO MDI The Colorado Medical-Dental Integration Project

Could innovative RDH practice models increase access to care and improve outcomes for high-risk populations?

CO MDI

Colorado Medical-Dental Integration

Five-Year Initiative

Launched in 2014

$3.3 million in funding

Integrates a hygienist in medical practices to provide preventive services

Expanding Access

Improving Oral Health

Testing Sustainability

CO MDI project goals

16 medical organizations

Outputs

What must happen to

achieve short-term outcomes?

Complete start-up activities and coaching model

MDI stories

Data Evaluation

Practices integration

Coaching activities

Inputs

What resources

will we need to invest?

Funding from DDCOF

Research: UCD - ACCORDS

Other Partners:Steering

CommitteeCO MDI

PracticesCF3-CDPHE

Activities

How are we going

to do what needs to

get done?

Apply Colocation 1.0 lesoons

Create MDI spaceHire RDHs

Educate practice about oral healthProvide technical

assistanceConduct

evaluation

What do we achieve in 1-3

years?

1.Collect metrics

2.Describe factors that facilitate, create barriers

3.Policy/system changes

4.Leverage other state projects

Embracement of child oral

health

Measured as:

Intermediate Outcomes

What do we achieve THIS

YEAR?

1.Baseline characteristics

2.Start-up/services

3.Referral relationships

4.Stories

Implement and refine MDI

modelsMeasured as:

Short-Term

Outcomes

Long-Term Outcomes

What are we trying to

accomplish after 3 years?

1. Identify models to replicate

2. Develop MDI toolkit/white paper

3. Improve child oral health

4. Impact policy

Measured as:

CO MDI Logic Model

Sustainable MDI business

modelsMeasured as:

Full scope

Integrated, team-based care

Familiar and comfortable for families

Extension of dental home

What makes CO MDI different?

Services Offered Risk assessment/screenings

Oral health instruction

Fluoride varnish application

Cleanings

Sealants

X-rays

Scaling & root planing

Referrals & case management

Coordinated Care

Co-Located Care

Integrated Care

Integrated Care

Communication* Care team huddle * Review medical schedule and identify patients

Clinical Delivery* Dental hygiene room in medical clinic * Medical exam room

Follow-up* Treatment planning with medical team* Restorative care referral and follow-up * Recall appointments scheduling

Support grantees in reaching project and organizational goals Provides accountability to

maximize patient visits Build integrated model

Coaching for success

The Federally Qualified Health Center Experience

Valley-Wide Health SystemsDenver Health School Based Health Centers

Evaluation & Patient highlights

Multi-Level, Mixed

Methods Evaluation

Leadership interviews

Provider surveys

RDH interviews

Monthly process metrics

Patient satisfaction

surveys

Monthly dental disease

Financials

Access to care

Insurance status

Services provided

% No dental visit in past 12 months

39.48%

Patient visits with untreated decay

7,596 patients referred. At least 58% of referrals have

completed at least one visit to dentist.

Patients referred to dentist

Clinics are on track to be financially sustainable and are considering expansion.

What have we learned?

Leadership vision Provider engagement Fit for the RDH position Capacity for coaching Adequate staffing time Team-based care experience

Success factors

Challenges and barriers

Limited buy-in and engagement Practice size, population focus and

payer mix Learning curve understanding dental Reimbursement mechanism Staff and provider capacity and

involvement RDH hiring decision

Allison Cusick, MPA, CHESSenior Program Officer

Delta Dental of Colorado Foundationacusick@ddpco.com

720-489-4711