Dr. Jim Thommes has seen for years how preventive care and lower costs go hand in hand. Now, he says, it’s time to take the next step.A leader in Preventistry, Dr. Jim Thommes says he asks himself every day, “What ideas can I come up with... that will improve the oral health care of all?”
Dr. Jim Thommes has witnessed the evolution of preventive care in dentistry throughout his career both up close and at a high level. As a clinical provider and longtime benefits administrator, he’s helped to identify trends — anecdotally and from raw data — when it comes to patient care. As Vice President of Clinical Management at DentaQuest, he works on a national level to support holistic care and Preventistry by offering guidance and proposing solutions from within the benefits space.
What drives you in your role each day at DentaQuest?
Every day I ask myself, “What ideas can I come up with today or be involved with that actually move things forward, that bend that cost curve, that improve the oral health care of all?” And I know that by working to improve health care for all, that means I’m also helping drive costs down.
What are some of the biggest changes you’ve seen in oral health care over the years?
I think the greatest evolution has been in technology. The computer systems in dental offices used to be good for scheduling, but now they’re more advanced. Offices can see what they’re doing and follow their own metrics. And on the insurance company’s side, we’re able to develop things that can better track “tooth life,” and see trends in what’s happening to the overall population. This means there are a lot more analytics that can help providers.
Generally, a dentist thinks of their own microcosm of a population — their patients — but we can look at it globally. We use data from more than the single provider to establish norms and try to improve the baseline in terms of health and cost. For example, we look at how often patients are coming back for preventive care — what that timeframe was, who was seen, who was not — and then inform the provider: “Here are how many patients are getting seen, and here’s an opportunity to provide better health to your patients and the population.”
What group do you consider to be the most in need when it comes to oral health?
I do a lot of work in the Medicaid world, and Medicaid benefits for children are usually fairly rich. They have just about everything available to them. But they’re dependent on mom and dad or their guardian to get to see a dentist. The child’s barrier to care could be that their parents have a job and can’t take time off for a cleaning, or that their parents don’t have the information or tools to know things like their child shouldn't go to bed with a bottle of juice. There is this societal acceptance that dental care for young kids isn’t important because people [inaccurately] think, “Well, they’re just going to lose those teeth.” So even though children have all the right benefits to cover what they need for optimal oral health, they are not self-reliant. In this case, it’s not improving access as much as it’s educating their parents about oral health.
What do you think the next iteration of Preventistry will look like?
Dentistry has always been geared toward prevention. When insurance policies came around, they keyed in on that, offering preventive services without a deductible, thus incentivizing patients to go. Now we’re taking it to the next step, and this is where DentaQuest is a leader.
We understand prevention, so now we’re trying to bend the cost curve by looking for higher-quality prevention through the mechanisms we put out there, whether it’s your typical exams and fluoride application, or sealants and silver diamine fluoride [two underutilized approaches to prevent and treat early decay]. We’re trying to get away from the higher-cost, irreversible things like extractions and fillings. In fact, we know we can avoid that cycle by keying on Preventistry — by expanding and rewarding providers who are prevention-oriented. I know DentaQuest recently released a report that supports this with validation from dentists, physicians, patients, employers, and Medicaid dental administrators.
(According to DentaQuest’s Reversible Decay report, nearly three-quarters of dentists agree that dental insurance should prioritize healthy outcomes over volume, and that value-based care “helps their organizations improve patient outcomes and reduce costs.”)