Risk Driven Capitation Models
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Dental capitation plans are a relatively recent concept. They should equitably spread the predicted monthly cost of care so as to provide financial assurance to patients and to clinicians. This cost may take into account both patients’ historic needs and current disease states, and should ideally also include an assessment of predicted clinical risks.
Plans should provide for individual, appropriately timed reviews, care and treatment based on these needs and risks, and should promote self-care by the patient as well as a preventive ethos whereby both parties—clinician and patient—are motivated to achieve optimally reduced needs and future risks of disease. By inference this will ideally reduce costs and resources, enabling the dental team to care for more patients, thus serving the interests of all.
Capitation plans should aspire to promote a dentist-patient partnership approach, with each party striving towards a longer-term objective of optimal oral health. Ongoing clinical risk assessments can support efficiency, enable effectiveness and demonstrate good outcomes.
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