Final Minus Gerta Summer Institute Slide Deck - Pratice Managment

Practice
Management
Dental Safety Net
Summer Institute
Division of Population Oral Health
Welcome & Introductions

Agenda
9:00 am – 9:15 am Arrival and coffee
9:15 am - 9:30 am Welcome Amy Martin
9:30 am – 10:15 am Overview of Best Practices for Dental Safety Net Practice
Management
10:15 am – 11:00 am Small Group Activity –
• Productivity benchmarks & strategies to narrow the gap
11:00 am – 11:45 am Debrief from activity
11:45 am– 12:00 pm Leadership efficacy assessment reflection; practice

management and finance
12:00 pm – 12:30 pm Catered Lunch
12:30 pm – 2:00 pm Keynote – SC Medicaid Process and Policy Gerta Ayers
2:00 pm – 2:30 pm Debrief and Dismiss Amy Martin
None of today’s speakers have a financial or conflict of interest with the program. This program is funded through HRSA/Bureau of Health Professions (T12HP28882).
Summer Institute Materials
• The Dental Safety Net Summer Institute materials
are available to each participant via the platform
Box.
• Each participant has received a personalized
invitation via email.
Improve knowledge of performance benchmarks for safety
net dental clinics
Improve knowledge of best practices for dental safety net

operations and practice management
Learning
Objectives
Improve knowledge of the claims process and policies
administered by SC Medicaid
Demonstrate how changes in the adult dental benefit in

Medicaid potentially impacts the financial performance of
their programs
I am confident in my ability to apply my
knowledge of finance terms & approaches
to ensure a financially viable safety net
dental practice or program.
I am confident in my ability to develop a

financial strategy, which includes goal
setting, for a safety net dental practice.
Practice I am confident in my ability to determine
Management financial goals (bottom line) for a safety
net dental practice or program.
Applications for
your Leadership I am confident in my ability to analyze
financial reports for a safety net dental
Improvement Plan practice or program that monitors
performance towards my goals.
I am confident in my ability to adjust

financial plans for the practice-based as
needed.
I am confident in my ability to
communicate financial reports with my
dental team.
Practice
Management
101
• How involved are you in the
financial & production
reporting of your dental
operations?
• Do you participate in
report generation or
Straw Poll interpretation?
• How, if at all, do you use
financial and practice
management reporting for
quality improvement? For
managing or evaluating your
team or yourselves?
1. Number of dental visits 7. Current fee schedule
• Denominator for other data; • Alignment with usual & customary
productivity fee of area & what insurers are
willing to pay
2. Number of total unduplicated
8. Number of completed Phase 1 Tx
Key Practice patients
• 2.5 visits/patient
and Tx completion rate
• Quality measure for meeting
Data • <2.5 = failure to complete Phase 1
tx plans
• >2.5 = service unbundling 9.
patients’ needs
Aging Report
• Performance of the billing process
3. Number of new dental patients (past due 30, 60, 90 days) &
• Measure of access and capacity for abilities of the billing team
new patients
10. *Broken appointment rate
4. Number of emergency visits • Measure of disruption & ‘chaos’ in
• Financial impact; ratio to regular the clinic
care
11. Transaction Report
5. *Dental policies for no-shows, • Scope & # of services at each
emergencies, scheduling, payment appointment
for dental care, & sliding fee
• Policy enforcement; equity in care 12. *Provider Productivity
• Daily performance measures based
6. *Profit & Loss Statement on goals & benchmarks for each
• Financial sustainability of the team member
practice
Practice Management is also Patient Management!

Scheduling
Policies
Goals • Clinical protocols that define services
1. Improve practice efficiency provided by visit type
2. Improve financial sustainability • Appointment time length
• Number of appointments available in the
3. Reduce chaos daily schedule to meet practice goals for
4. Increase predictability patient & payer mix
• How far in advance appointments are
scheduled
Profit
and
Loss
Best Practices: Scheduling
• BEST PRACTICE: schedule appointments out • BEST PRACTICE: allow only designated &
no further than 30 to 45 days trained staff to schedule
• Eliminates long waits • Promotes uniformity
• Increases Phase 1 tx plan completions
• Creates accountability and leadership in
• Decreases no-shows/cancellations staff roles
• BEST PRACTICE: schedule appointments one • BEST PRACTICE: use a template that
at time manages patient and payer mix for maximum
access and fosters Phase 1 tx plans
• After a visit, the next subsequent is
completion & promotes financial
scheduled
sustainability:
• (exception) patients who need a series
of visits for endo or prosth related care • Mission of practice goals defined.
• Financial and productivity goals
• Create & distribute a strong, no-tolerance BA policy to
establish accountability with patients and staff
• Consistently enforce the no-show policy, despite negative
feedback. Everyone affiliated with the program must agree
(including BOD).
Best Practices: • Provide scripts for staff when patients question the policies
• Patient contracts as show of commitment to policy
Managing • Provide reminders to patients 48 hours prior to appointments
Broken • Flag charts for those who have breached policy and send
letters reminding them of their commitments
Appointments • Emergency patients should call back to schedule follow-up
appointments a few days after the emergency
• Limit number of new patients each day
• Do not schedule appointments for family members on same
day unless they have a demonstrated record of reliability
• NOT A BEST PRACTICE? Overbooking.
Broken
Appointments
• Ideal is 15% or less
Phase 1: Treatment Completion
• Phase 1 Tx include…
• Level 1 – Emergency • BEST PRACTICE – Begin tracking
• Level 2 – Primary (prevention) completion using a dummy code in
• Level 3 – Secondary (restorative) your practice management system.
• (not considered Phase 1) Level 4 – Limited • BEST PRACTICE – Create &
Rehabilitation (crowns, dentures, etc.) implement standardized clinical
protocols intended to complete
Phase 1
• BEST PRACTICE – see previously
described strategies for broken
appointments & scheduling
Production Benchmarks –
Tips for Maximum Efficiency
3rd chair used for 1.5 assistants per 2

EFDAs and hygienists
2 chairs per 1 FTE dentist emergencies, post-op operatories although 1
used at the tops of their
(3 operatories for checks, denture DA per operatory
licenses improves
maximum effiency) adjustments, tx plan provides maximum
production.
presentations & consults efficiency.
How does your
practice compare?
Using
Benchmarks to
Determine Visit
Goals: Dentists
and Hygienists
Hygiene Productivity Goals: The productivity benchmark for

hygienists is 1-1.2 visits per hour and not included in the
table because the variables do not apply. In standard
community dental clinics, a hygienist works out of one
operatory without a dental assistant. One consideration is
patient population; practices with a mix of adults and
children should use 1.2 as the visit/hour benchmark and
clinics mostly serving adults should use 1 visit/hour as the
benchmark for hygienists.
Summary
Clinical vs. Business

Planning – the two are Evaluation against
Sustainable practice
interconnected in benchmarks creates quality,
management is a journey,
sustainable practices but accountability, and
not a destination
usually segregated improved access
operationally
Productivity benchmarks & strategies to narrow the gap
Making Changes
• What do you think are the root causes of falling short or exceeding
published benchmarks?
• What from the manual could be adopted to help them improved
performance?
• Discuss and identify 1 to 3 things your practice that could done
differently to improve performance.
Small Group Advocating for Changes
Activity • Looping back to advocacy at the organization level, how will you go
about advocating for these changes?
• What do you think the anticipated and unanticipated impact of the
changes will be?
Leading Changes
• What in your personal leadership enhancement plan will you prioritize
to lead improvements in practice management for your organization?
• What resources do you need to achieve your personal goals/priorities
as a dental leader?
Small Group Activity:
DEBRIEFING
Lunch
Keynote
Mrs. Gerta Ayers
(Keynote Speaker Notes Redacted)
Debrief and Dismiss

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Practice

Welcome & Introductions

9:15 am - 9:30 am Welcome Amy Martin

11:00 am – 11:45 am Debrief from activity

11:45 am– 12:00 pm Leadership efficacy assessment reflection; practice

12:30 pm – 2:00 pm Keynote – SC Medicaid Process and Policy Gerta Ayers

2:00 pm – 2:30 pm Debrief and Dismiss Amy Martin

Improve knowledge of best practices for dental safety net

Demonstrate how changes in the adult dental benefit in

I am confident in my ability to develop a

I am confident in my ability to adjust

Practice Management is also Patient Management!

3rd chair used for 1.5 assistants per 2

Hygiene Productivity Goals: The productivity benchmark for

Clinical vs. Business

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