From Where I Sit Page 2

Weekly Biological Testing Page 4

SBIRT & Caries Risk Assessment Page 6

Changes to HIPPA Page 8

OHP Provider News Page 10

Commercial Provider News Page 12

CCO News Page 13

Regions & Representatives Page 13

Dental Outcomes & Performance Metrics Page 14

BMI Page 15

New Providers Page 16

Social Networking Page 17

Classifieds Page 18

Calendar of Events Page 20

I N S I D E T H I S I S S U E :

O U R M I S S I O N : To provide dental leadership, service and access to care to our communities in a professional, entrepreneurial and sustainable manner

It’s a New World page 2

The AdvantageThe Advantage Community Newsletter

From Where I Sit:

3rd Quarter 2013

2 | The Advantage 3rd Quarter 2013 | 3

I have written many times about the new

healthcare world that is being envisioned

by the government through the Affordable

Care Act (ACA) and the Oregon Health

Care delivery system transformation

legislation (HB3650, SB1580, & HB 2009)

among others

As I talked before; Government, (city,

county, state, Federal, Medicaid, Medicare,

military, the VA and Tribes), pays for over

60% of the cost of Health Care in this

country Because of this, they would like to

change the Healthcare delivery system—

which is really a ‘sick care’ system The new

world is about a group of providers taking

on the financial risk for a group of patients

and promising certain outcomes Rather

than providers waiting in their offices for

people to show up with problems—then

getting paid a fee for service to fix the

problem; having to arrange with some

third party payer to pay the bill and being

frustrated by the fact that our ability to

fix the problem out strips the patients’

ability to pay and the third party payer’s

willingness to pay—the practice will be

paid a fixed rate to take care of a number

of patients; taking on a substantial fiscal

risk that the patients they are seeing will

need more care because of poor health

and/or health habits

The problem is, now that government pays

the majority of the bill, they do not want

to buy what we have to sell What they

want now, is to buy healthy people who

do not need their expensive problems

fixed Because the government cannot

really assess quality of work (because they

are not dentists) they will want to find

quantitative ways to measure how well

we are taking care of the patient’s needs

They may want to track documentation,

patient satisfaction, spending on services

such as; hospital ER, prescriptions, number

of procedures such as sealants done,

permanent molars, or even the number of

people with a dental visit of any kind

So if the government is not paying for

procedures, what do they want us to

do? They want us to become involved

with our communities and help the

community to help its citizens achieve

overall better health—which includes

oral health The problem is that people

have become convinced that the solution

is to have their teeth fixed when they

have a problem; and, as an industry, the

incentives for payment minimized the idea

that prevention can be the better (less

expensive) solution

This entire process is starting with

Medicaid—which the majority of you

reading this newsletter do not treat Some

of you are desperately trying to avoid the

system used in Medicaid dentistry in your

commercial work This group of Dentists

may find that they cannot avoid it much

longer Government is starting to ask why

so much dentistry needs to be done on

the people with commercial insurance

They are looking at how their employees

can have less disease, thus fewer repairs, as

well An article about this was in the ADA

Journal The article, by Dr. Christensen, is

It’s a New WorldChange is inevitable, but everyone still needs Teeth

By R. Mike Shirtcliff, DMD

From Where I Sit:

questioning the need for so many crowns

My prediction is that you will see more

and more articles in the future about

the concept of disease prevention and

finding ways to avoid expensive restorative

procedures The ADA newsletter has

published a series on this subject with

titles such as, “The New Normal”

Also, you will begin to see a lot of articles

about government programs such as

spore testing for autoclaves Please read

them and do what it takes to stay current

As a subcontractor to Advantage Dental,

Advantage Dental will also have to do

some auditing to prove to our government

masters that we are all complying with

the law

Advantage Dental and PacificSource are

rolling out a new commercial product

in January that will pay dentists who

participate on a monthly capitated

payment, plus co-pays, for certain

procedures At first, only those providers

that take a large enough block of

Oregon Health Plan (OHP) patients to

minimize the risk, and are familiar with

how capitation works, will be afforded

the opportunity to participate This new

product will be offered only to large

groups that want dual choice; similar

to what ODS & Willamette is offering

This will be a limited offer at first; so if

you are interested please let Advantage

Dental Customer Service know at

providerrelations@advantagedental.com

As always, thank you all for what you do

to serve the citizens of your respective

communities The world is changing, but

some things remain the same All people

have and need teeth

Government is starting to ask why so much dentistry needs to be done...

4 | The Advantage 3rd Quarter 2013 | 5

L���� � C�n����

$6,000 �ne + 40 hours Community Service1 Missed Test = 1 Fail

0 20 5

Within this past year all Board

investigations have included inquiry into

sterilization practices Those investigations

have determined that nearly 75% of

practicing dentists have been less than

diligent in undertaking weekly biological

testing of heat sterilizing devices

The requirement of undertaking weekly

testing is established by Oregon

Administrative Rule 818-012-0044(4),

(See opposite page for rule text) This

rule has been in place for many years,

but has not been a point of awareness

for many dentists or the Board until the

recent sterilization failures in Oklahoma

that made national news (Note that the

events in Oklahoma involved the complete

and actual disregard for sterilization, as

opposed to the failure to perform a weekly

test on sterilization equipment)

In response to the poor testing compliance

in Oregon , the Board has crafted a tiered

disciplinary system Each missed weekly

test is deemed a failure If a dentists has

0-5 failures, the board may issue a letter

of concern If the dentist has 6 or more

failures, the Board may issue discipline

on a tiered scale The highest level on the

scale is for 20 or more failures; for which

the Board may impose a $6,000 fine and 40

hours of community dental service or more

By virtue of the tiered system, the

highest level of discipline incorporates

those individuals who may have been

testing every other week as apposed to

every week The lesser disciplinary levels

incorporate those dentists who may have

had staff turnover of similar administrative

lapses In all circumstances, however, the

ending Consent Orders are discipline that

is publicly published by the Board and

reported to the National Practitioners

Data Bank

In the vast majority of cases, the testing

failures have been due to a minor

administrative lapse or failure of a dentist

to fully appreciate that weekly testing

was mandated Given that the failure

rate nears 75% of all practicing dentists,

the failures include some of the best and

most conscientious of providers This

includes former Oregon Dental Board

Members as well as former Presidents of

local Dental Societies; all people who have

dedicated themselves to dental excellence

and would not knowingly violate a

sterilization mandate In addition, in some

Weekly Testing Is MANDATED by the Oregon Board of Dentistry

Penalties for not conducting weekly biological testing of sterilizing devices can be costlyIs YOUR Office testing bi-weekly?

…the failure rate nears 75%

of all practicing dentists, the

failures include some of the

best and most conscientious

of providers. r

Watkinson Laird Rubenstein

Baldwin & Burgess, P.C. Announces the Addition of

New Shareholders:

James R. Dole

John J. Christianson

Jane M. Yates

New Offices In:

Portland and Grants Pass

Providing legal services to healthcare practices,

individuals, and businesses throughout Oregon

in the areas of:

• Health Law

• Employee Benefits and Personnel Issues

• Real Estate and Business Transactions

• Estate Planning and Asset Protection

• Litigation and Family Law

Eugene Roseburg Redmond

Portland Grants Pass

www.WLRLaw.com (800) 270-7418

Oregon Board of Dentistry Infection Control Guidelines 818-012-0040

In determining what constitutes unacceptable patient care with respect

to infection control, the Board may consider current infection control

guidelines such as those of the Centers for Disease Control and Prevention

and the American Dental Association Additionally, licensees must comply

with the following requirements:

(1) Disposable gloves shall be worn whenever placing fingers into the

mouth of a patient or when handling blood or saliva contaminated

instruments or equipment Appropriate hand hygiene shall be

performed prior to gloving

(2) Masks and protective eye wear or chin-length shields shall be worn

by licensees and other dental care workers when spattering of blood

or other body fluids is likely

(3) Between each patient use, instruments or other equipment that come

in contact with body fluids shall be sterilized

(4) Heat sterilizing devices shall be tested for proper function on a

weekly basis by means of a biological monitoring system that

indicates micro-organisms kill.

(5) Environmental surfaces that are contaminated by blood or saliva shall

be disinfected with a chemical germicide which is mycobactericidal

at use

(6) Impervious backed paper, aluminum foil, or plastic wrap may be used

to cover surfaces that may be contaminated by blood or saliva and

are difficult or impossible to disinfect The cover shall be replaced

between patients

(7) All contaminated wastes and sharps shall be disposed of according to

any governmental requirements

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circumstances contract dentists or employed dentists are receiving Consent

Orders due to the administrative failings of their employers

Earlier this year, the Dental Board issued notice to all providers reminding

them of their testing requirements This effort at education is working as

awareness for the weekly requirement is increasing However, while the effort

to inform is beneficial, there has been no concurrent effort to raise awareness

regarding the level of discipline that is being issued

6 | The Advantage 3rd Quarter 2013 | 7

Poverty is a risk factor that impacts many areas of our

communities and citizens – education, health, and child safety

are just a few of these areas In terms of health, Bridges Out Of

Poverty says, “The poorer you are the sicker you are ” Apply that to

the Oregon Health Plan population, most of whom live in poverty,

and we health professionals will see more individuals with

comorbid interrelated health issues For example, dental patients

with obesity, high blood pressure, substance abuse, tobacco

addictions and a mental health diagnosis

The day-to-day lives of these individuals make engaging in dental

care difficult Scrambling from one agency to another to find

the resources to meet their basic needs might make their lives

look like tornadoes They tend to be focused on the crisis of the

moment with little time or energy to focus on tomorrow, next

week or next month Survival needs of food, utilities, housing,

keeping a car running, or needs of family members in the same

situation often take priority over keeping dental or medical

appointments A lack of education about how good oral health

affects overall health or the importance of baby teeth in children

can keep parents from accessing dental care

As Advantage Dental transitions into contracting with 16

Coordinated Care Organizations (CCO) the view of dentistry

will need to shift to assisting in coordinating care, which will be

outlined in this article Topics to be discussed are SBIRT (Screening,

Brief Intervention and Referral to Treatment), Caries Risk

Assessment, Prevention strategies, and Bridges Out of Poverty

SBIRT (SCREENING, BRIEF INTERVENTION AND REFERRAL TO TREATMENT)

Integrating dental into the global budget of the CCOs will require

the dental team to help meet the measures of each CCO The

Oregon Health Authority has identified SBIRT as an incentive

funding measure for Oregon’s Coordinated Care Organizations

SBIRT is evidence based and determined to be an effective

method to intervene in alcohol and drug misuse In the past it

has been underutilized in the primary care setting Research has

shown that patients tend to show up in the dental office more

often than the primary care office Given this, dentistry has the

ability to reach a subset of folks with this intervention that may

otherwise go unscreened and without intervention

Oregon SBIRT Primary Care Residency Initiative, sited at OHSU, is

one of the largest training programs with the goal to teach SBIRT

method to primary care physicians Advantage Dental would like

to take this a step further by training the dental team as well For

more information on SBIRT and the Oregon training program visit:

www.SBIRToregon.org

When the simple act of putting food on the table for your family becomes the focus of your daily life and Oral Health looks like an impossible luxury

The view of Dentistry will need to shift:

— Cindy Shirtcliff, LCSW and Sharity Ludwig, BS, RDH, EPP

CARIES RISK ASSESSMENT

The American Dental Association has completed some revisions

that will be coming into effect January 2014 The ones of

most interest to Advantage Dental will be the new Caries Risk

Assessment codes, which will provide a standard means of

reporting Caries Risk for dental professionals These codes will

allow the opportunity for dental insurers to start paying for

different levels of care based on the identified risk of an

individual patient

Advantage Dental expects that a Caries Risk Assessment will

be an initial part of treatment on every individual with the

expectations to provide treatment according to risk status For

example, according to the ADA Evidence Based Guidelines, a

low risk patient would not benefit from receiving an in office

fluoride treatment It is recommended that daily use of fluoride

toothpaste is adequate The patient identified as High Risk would

require 2-4 applications per year

Dental prevention without using caries risk is not cost effective

and is actually cost prohibitive It is necessary to identify those at

high risk and work toward moving them to a lower risk category

and keeping those at low risk stable Advantage Dental recently

partnered with DHS’s Self-Sufficiency Program in doing outreach

home visits to parents who had not accessed dental care for

their children after school screenings had deemed them needing

urgent or emergent dental care This outreach began with 5

families Interestingly, 2 families out of the 5 were homeless As

a family attending to survival needs of shelter, food and keeping

a car running, it seems it was hard to put dental care at the top of

the list One single mom works 12 hours a day during the week

Another had a phobia of going to the dentist she did not want

to impart to her young child Not knowing how to get help, she

avoided taking him to the dentist

Let’s face it, missing appointments or not seeking free dental

care or health care can frustrate all of us as providers We

have all used terms like “resistant,”, “unmotivated,” and “non-

compliant” to describe our patients who don’t show up or change

behaviors Advantage Dental is training its providers and staff

in the understanding of the Culture of Poverty The hope is that

with understanding will come more empathy and less judgment,

thus reducing a barrier to care We are helping staff to remember

that our societal experiences may be different than those of our

patients

Living without adequate resources will place many OHP patients

in the “high risk” category on the Caries Risk Assessment

Therefore, Advantage Dental will be promoting individualized

preventative treatment plans to address the level of risk For

a younger child at high risk it would include 4 betadyne and

fluoride varnish treatments before the age of 30 months Another

example would be early dental care for a pregnant woman and

the use of Xylitol products

In the next few months an Advantage team will be conducting

trainings around the topics of Prevention, Caries Risk Assessments,

SBIRT and the Culture of Poverty These will initially be webinars

for the convenience of staff to attend from their offices and

minimal loss of work time

The new codes for 2014 will be:

D0601 caries risk assessment and documentation, with a

finding of low risk using recognized assessment

tools

D0602 caries risk assessment and documentation,

with a finding of moderate risk using recognized

assessment tools

D0603 caries risk assessment and documentation,

with a finding of high risk using recognized

assessment tools

For more information on Caries Risk Assessment:https://secure.advantagedental.com/images/files/

PreventionManualSec1.pdf

http://www.ada.org/sections/professionalResources/pdfs/

topics_caries_under6.pdf

http://www.ada.org/sections/professionalResources/pdfs/

topic_caries_over6.pdf

http://www.cdafoundation.org/learn/education-training/

cambra

http://ebd.ada.org/ClinicalRecommendations.aspx

8 | The Advantage 3rd Quarter 2013 | 9

There have been substantial recent

changes made to HIPAA which required

compliance by September 23, 2013

To ensure that your office has met the

compliance requirements, we recommend

that you consult with your attorney and/

or HIPAA specialist For your information

only, below is a list of resources that you

may find useful

Resources:

¾ HIPAA Administrative Simplification Regulation Text provided by the Department of Health and Human Services Office for Civil Rights

� http://www.hhs.gov/ocr/privacy/hipaa/administrative/combined/hipaa-simplification-201303.pdf

� This document includes information related to the new HIPAA provisions

¾ HIPAA Privacy and Security web page provided by the American Dental Association

� http://www.ada.org/8753.aspx

� This website provides an overview of the new HIPAA provisions and explains how such provisions could affect dental offices

¾ Department of Health and Human Services website

� http://www.hhs.gov/ocr

� This website provides detailed information regarding the new HIPAA provisions as well sample Business Associate Agreements

¾ HIPAA training materials from the Department of Health and Human Services

� http://www.hhs.gov/ocr/privacy/hipaa/understanding/training/index.html

� This website includes links to two

videos and a handout, all which review the new HIPAA provisions The first video, “Patient Privacy” is geared toward doctors and healthcare providers; the second video, “HIPAA and You” is geared toward healthcare providers in general; and, the handout, “Examining Compliance with the HIPAA Privacy Rule” is geared toward healthcare providers who regularly interact with PHI

Please Note: Advantage Dental in no

way guarantees the accuracy of the

information contained in these resources

and Advantage Dental does not intend

any of the resources to constitute or

take the place of legal advice from your

own attorney Furthermore, Advantage

Dental does not endorse and will not

take responsibility for the accuracy of the

information provided by these resources

PAC-078_DENTAL_AdvantageDentalNewsltr_4.625x3.5_Q2-2013.indd 1 4/24/13 3:52 PM

Changes to HIPAA

The Good Shepard event was a great time for the Hermiston, Heppner and Boardman clinic staff. They did 85 dental screening and put the new Eastern Oregon Advantage Communities brochure in hundreds of hands.

Wondering why you should be an Advantage Dental Provider?Call us at:

866-268-9616or e-mail

providerrelations@AdvantageDental.com

Super Advantage Smiles for Kids (ASK) Donation OpportunityOnline shopping for the Holidays? Amazon com just launched AmazonSmile:

Go to AmazonSmile through your online Amazon account

Be sure to type in Advantage Smiles for Kids as your charity of choice

5% of every dollar you spend will be donated to ASK!

Happy Shopping!

Oregon Health Plan Provider News

10 | The Advantage 3rd Quarter 2013 | 11

Help us, help your patients by following

these guidelines when Submitting your preauthoraiztionfor third molar extractions.EVIDENCE OF INFECTION: The most

important thing looked for is evidence

of acute infection or abscess If there

is good evidence of acute infection

or abscess, it’s usually approved

Unfortunately, documentation to

evaluate for acute infection is usually

lacking There is a lot of documentation

for pericoronitis but, technically, this

only means inflammation and it does not

necessarily mean there is an infection

Pericoronitis was the most common

dental emergency seen in the Army

because most young soldiers enlisted

before they had their third molars

removed Pericoronitis can often be

treated by debridement, irrigation, anti-

inflammatory medication and home care

instructions It should not be necessary

to extract third molars because of one

episode of pericoronitis

PAIN: Pain is the most subjective and

the most difficult symptom to evaluate

because some discomfort is expected

for erupting third molars and tolerance

for pain differs from one person to the

next If the tooth is confined within the

bone, incompletely formed and appears

to be causing pressure symptoms rather

than pain from infection, the patient’s

complaint of pain cannot be relied on

as the sole reason for extraction The

OHP rulebook states the pain must be

“severe”

SWELLING: Swelling is also difficult

to evaluate because, like pain, mild to

moderate swelling is common with

erupting third molars (the tooth pushes

the gum tissue up as it tries to erupt

– this is normal “swelling”) The OHP

rulebook states that there must be

“unusual swelling of the face or gums”

CARIES: Caries is not addressed in the

OHP rules as a reason for extraction, but

will be allowed when there is deep decay

and the tooth is clearly non-restorable,

even if it’s not symptomatic because it

will become a problem eventually If

there is only early decay extractions are

not normally approved because they are

not listed by OHP as one of the criteria

DOCUMENTATION: Other

documentation that helps determine

if acute infection is present includes

suppuration from beneath the

operculum or around the tooth,

regional lymphadenopathy, elevated

temperature, trismus and history of

antibiotic prescriptions

POTENTIAL FOR INFECTION: Another

consideration is the potential for

infection in medically compromised

or pregnant patients If there are deep

perio pockets behind the second molars

with a partially erupted third molar, I

usually approve the extraction rather

than put a medically compromised or

pregnant patient at risk for infection

This is not a consideration in healthy

patients

EXTRACTIONS OF THIRD MOLARS IS SURGERY

Something you should remind your

patients of is that extraction of third

molars is surgery and it has risks

for operative and post-operative

complications including infection,

bleeding, and nerve dysfunction These

complications are uncommon but

they should be considered As with

any other invasive medical or dental

procedure, surgical removal of impacted

third molars should be done only when

necessary and it should be after a risk:

benefit analysis

Regarding Approvals and Denials of Preauths for Third Molar Extractions

ARE YOU PRESCRIBING XYLITOL GUM or MINT KITS FOR YOUR OHP PATIENTS?

Part of Advantage Dental’s Caries Protocol for the high-risk patient is to have a preventative

protocol in place to reduce the level of dental disease Because of this, Advantage is offering

xylitol products to patients Patients who are pregnant* and with special heath care needs**

will be provided a 90-day kit at no out of pocket expense (Bill out D9630) Those who do not fall

into either of those categories can purchase the kits for $28 In this case the kit will be mailed

out once payment is received by Advantage Dental Administration

* All patients who are pregnant or less than 3 months postpartum should be given a 90-day

supply of xylitol with instructions to use for 3 months after delivery If patient has rampant

decay then the patient should be put on xylitol protocol for 6 months after delivery

** Patients with developmental, physical, medical, or mental disabilities that prevent or limit

performance of adequate oral health care by themselves or caregivers Provide patient xylitol

until dental disease is under control

Did You Know, You can purchase kits too!Xylitol: Nature’s Cavity Fighter, $28.00 per kit

Gum Kit:

• 1 bottle (50 pieces each) of Xylitol Gum and one bulk bag (500 pieces) of Gum Your choice of Cinnamon, Fruit, or Peppermint

• 1 Tube of Xylitol Toothpaste

• Informational Brochure

Mint Kit:

• 1 bottle (200 mints each) of Xylitol Mints, and one bulk bag (1,000 pieces) of mints Your choice of Cinnamon, Fruit, or Peppermint

• 1 Tube of Xylitol Toothpaste

• Informational Brochure

—Gary Allen, DMD Dental Consultant

To order a 90-day xylitol kit or toothpaste call the Customer Service Provider Only Line (Please DO NOT share this number with your patients) 1-888-480-4478 Have patient’s recipient ID#, Last name, First name, and whether patient is pregnant, special health care needs, or OTHER and who will be paying the $28 for the kit

12 | The Advantage 3rd Quarter 2013 | 13

Your Representatives

Advantage Consolidated, LLC Board of Managers Region 1:

Dane Smith, DDS of North Bend, ORRon Tribble, DMD of Winston, OR

Region 2:

Greg Bigelow, DMD of Grants Pass, ORDon Lanahan, DMD of Grants Pass, OR

Region 3:

J Kyle House, DDS of Hood River, ORJames Petersen, DMD of Prineville, OR

Elected At Large Region (Entire State of Oregon):

John “Jack” Bauer, DMD of Burns, ORThomas Tucker, DMD of Klamath Falls, OR

Appointed At Large Region (Entire State of Oregon):

Cedric “Ced” Hayden, DDS of Springfield, ORMatthew Hayden, DDS of Hermiston, OR

Lay Managers:

Bruce Hanna of Roseburg, ORMike Gordon of Coos Bay, ORRob Keith of Lebanon, ORJohn Thomas of Eugene, OR Jerry Duncan of Roseburg, OR

B Unit Non-Voting Manager:

Sylvia Goedeck of Prineville, OR

President/CEO Non-Voting Manager:

R Mike Shirtcliff, DMD of Redmond, OR

Representatives for each region

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Are you treating Healthy Kids Connect patients through PacificSource? Healthy Kids Connect has been a traditional insurance program with a subsidy available that helped to pay the premiums to those that qualify. Since it was traditional insurance patients were able to see any provider that was contracted with Advantage to be a network provider for PacificSource. With the changes in health care, and Oregon’s reform process, the Healthy Kids Connect program will be changing as of January 1, 2014.

Healthy Kids Connect will become part of the Oregon Health Plan benefit offered through the Cover Oregon Marketplace. With this change, only providers that are contracted OHP providers will be eligible to treat these patients.

Please make sure your staff knows that for dates of service on or after January 1, 2014 you will not receive payment on any treatment of a Healthy Kids Connect patient, unless you are an OHP contracted provider.

Should you have any questions regarding this change, please feel free to contact Customer Service at 1-866-268-9631.

Commercial Provider News

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PacificSource Has OnLine ResourcesPacificSource has some great resources on-line. Besides their provider bulletin they also have a page dedicated to news of interest to Dental providers specifically. Here are some links to PacificSource resources to help you:

Provider Information Page

http://www.pacificsource.com/providers/

Provider Bulletin

http://www.pacificsource.com/provider/provider-newsletters/

Dental Providers Information Page

http://www.pacificsource.com/DentalProviders/

14 | The Advantage 3rd Quarter 2013 | 15

See more information on SBIRT in the article on page 6

You don’t need any special equipment or skill to assess BMI, so why not start screening your patients by calculating their BMI then counseling them to see their physician when needed BMI is an inexpensive and easy-to-perform method of screening for weight categories that may lead to health problems

The BMI ranges are based on the relationship between body weight and disease and death Overweight and obese individuals are at increased risk for many diseases and health conditions, including the following:

Body Mass Index (BMI) is a number calculated from a person’s weight and height BMI is a fairly reliable indicator of body fatness for most people BMI does not measure body fat directly, but research has shown that BMI correlates to direct measures of body fat To calculate BMI you only need to have the patient’s weight and height There are many on-line BMI calculators that you may use, but we recommend the one found on the Centers for Disease Control (CDC) website View the CDC Adult BMI Calculator go to: www.cdc.gov

For adults 20 years old and older, BMI is interpreted using standard weight status categories that are the same for all ages and for both men and women For children and teens, on the other hand, the interpretation of BMI is both age- and sex-specific

For more information about interpretation for children and

teens, visit Child and Teen BMI Calculator at: www.cdc.gov

For more information about these and other health problems associated with overweight and obesity, visit Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults on the CDC website at: www.cdc.gov

Performance metrics have always been

part of Advantage Dental’s OHP contract

with the state These metrics have

primarily focused on preventive services

for children and pregnant women and

provided benchmarks and trending data

to monitor quality improvement projects

Until now, they carried no penalties for

poor performance and no incentives for

improvement With implementation of

healthcare reform and integration into

Coordinated Care Organizations (CCOs),

new metrics will be developed to monitor

dental plan performance and financial

incentives will be added to improve

quality and outcomes

Recommendations for appropriate dental

performance metrics will be made by

a Dental Quality Metrics Workgroup

appointed by the Director of the Oregon

Health Authority (OHA) The workgroup

consists of 11 members—three from CCOs,

four from DCOs and four individuals with

expertise in oral health Dr Mike Shirtcliff is

one of the four DCO members appointed

to the Dental Quality Metrics Workgroup

The workgroup has already met several

times to review and discuss a variety of

dental metric sets

The Dental Quality Metrics Workgroup

will recommend up to five measures for

adoption by the OHA Metrics and Scoring

Committee no later than November 2013

Two of the measures will be selected

for inclusion in the set of CCO financial

incentive measures Criteria used by

the workgroup to select dental quality

measures include:

1 Representative of the services provided and beneficiaries served by the CCOs

2 Use valid and reliable performance measures

3 Rely on national measures whenever possible

4 Focus on outcomes to the extent possible

5 Exclude measures that would be expected to be heavily influenced by the patient case mix

6 Control for the effects of random variation (e g , measure type, denominator size)

7 Focus on the right care, at the right time, in the right place

Following implementation of the dental

performance measures, Advantage Dental

will be at risk to achieve quality goals

defined by OHA and CCOs While this

will be an important area of emphasis

for Advantage Dental as a dental plan, it

should not be our only focus Advantage

can show value added to its CCO partners

by helping them reach overall healthcare

quality measures OHA has identified

17 incentive measures where CCOs will

be expected to show improvement

Among these are several where oral

health providers can be trained to deliver

appropriate interventions to improve

overall health quality One of these is

alcohol and drug misuse Screening, Brief

Intervention and Referral for Treatment

(SBIRT) Some CCOs are sponsoring

SBIRT training throughout the state

and Advantage dentists and offices are

encouraged to attend

Other CCO measures, where dental

providers and dental plans have a role in

helping achieve better health outcomes

for Oregonians, include checking and

controlling high blood pressure, helping

control HbA1c levels in diabetics, reducing

tobacco use and reducing avoidable

emergency department (ED) visits This

new era of coordinated and integrated

health care offers opportunities and

challenges for all health care provider

types to step up and use their training,

knowledge and expertise to improve the

health of all Oregonian through a seamless

delivery system

BMI Weight Status

Below 18 5 Underweight

10 5–24 9 Normal

25 0–29 9 Overweight

30 0 and Above Obese

BMI ranges

Dental Outcomes and Performance Metrics

Let’s Talk AFS• Credit Reports• Patient Financing Consulting

(through Credit Matrix)• Patient Appointment Reminder Calls• Patient Payment Reminder Calls• Patient Reactivation Calls• Patient Hygiene Reminder Calls• Insurance Follow-up Calls

Would you like to improve your ability to provide patient financing and increasing the efficiency of your practice? Why not take a look at what Advantage Dental’s financial services can offer—starting at only $200 per month.

Become an Advantage Dental Contracted Provider and be eligible to participate in AFS, one of many Member Benefit programs available to our contracted Dentists.

Call 866-268-9616 or e-mail: ProviderRelations@AdvantageDental.com

• Hypertension• Dyslipidemia• Type 2 diabetes• Coronary heart disease• Stroke

• Gallbladder disease• Osteoarthritis• Sleep apnea and

respiratory problems• Some cancers

16 | The Advantage 3rd Quarter 2013 | 17

CCO News

No Matter Where You Are...Brad visits practices from Central Oregon all the way to the coast. His unsurpassed commitment and personable style is welcomed by all. If you are looking for a bank that goes the distance, give Brad a call.

www.columbiacommunitybank.com

Brad Volchok 503-924-2320Email: brad@columbiacommunitybank.com

Advantage Dental ad_5-13-13_F.pdf 1 5/15/2013 10:22:13 AM

ALLCARE and Western Oregon Advanced Health are now sending a pre-auth for pain medication AllCare has stated that either the pharmacy or the office can call AllCare at 541-471-4106 and advise that the script is for dental and request for an “acute fill override” which will be approved

Advantage Dental Services, LLC is now contracted with the following CCOs:Western Oregon Advanced Health (WOAH), July 1, 2013Intercommunity Health Network (IHN), October 1, 2013Primary Health of Josephine County (PHJC), October 1, 2013

Coming Soon:Trillium, January 1, 2014JCC (Jackson Care Connect), January 1, 2014

What Can the Social Network Do For Your Practice?

Social Media Do’s and Don’ts for the Dental Practice

We are bombarded with the message to

used social medial but most dentists are

still asking, “what is social media and what

can it do for my practice?” Why spend the

time and resources to interact with your

current and future patients this way?

Measuring the value of any social media

activity is tough There isn’t a lot of

quantitative data that can be examined to

show how affective or ineffective a social

media campaign is Not unlike the design

of your letterhead or website, the response

to social media is somewhat subjective and

often indirect

It’s difficult to put a hard value on that

positive comment posted to your facebook

page, but you know that there is value in

positive reviews & referrals that lead to new

patients

GONE ARE THE DAYS OF SHOTGUN ADVERTISING

People have become more sophisticated

in the process of making purchasing

decisions The information age has made

it possible for the customer to quickly and

easily research a product or service They

can now view reviews and comments with

a click on of a mouse or swipe of a finger

And people are making decisions based

on what they see online

Engaging your customer through social

media can lead to a drastic increase in

business The more relationships you can

build, the more your current customers

will talk and recommend you to their

friends, family and acquaintances Social

Media gives you a new tool to build trust,

loyalty and respect in your community

YOU CAN’T FAKE IT

Social Media may not be right for every

dentist People must engage with these

communities in a real way You will need

to be diligent in the management of your

on-line reputation Social Media can open

you up to criticism and it can be difficult to

deal with negative feedback

Many have decided that Social Media is

worth the risk For example; the father of

the creator of facebook, Mark Zukerberg,

advocates for Dentists to use facebook to

build their practice, (Read more about Dr

Zuckerberg at: http://articles.latimes.

com/2011/mar/30/business/la-fi-

zuckerberg-father-20110330)

THE NUMBERS ARE COMPELLING

More than 80% of American adults use

an online social network 23% of the

time an average user spends online is on

a social media platform With over one

billion facebook users—and close to as

many users on Twitter, Pinterest, LinkedIn,

MeetUp, Google+, and more—connecting

every minute of every day; why not take

advantage of the opportunity?

How are you going to use social media to engage with current

and future patents online? Here are some quick tips to help get

you started in your practice’s online marking strategy

1 Do Create Quality Content Social media presents the

opportunity disseminate engaging and information content

about your practice; and social media users demand it

2 Listen: Take the time to listen and find out what patients are

saying online Make time every week to read and respond to

patient feedback

3 Get Outside Help When Needed: Social Media takes time to

manage effectively If you think you may not be able to keep up,

don’t take the chance of dropping the ball Hire outside help

Advantage Dental’s preferred partner LocalFresh is one great

resource for this kind of help

—Kimberly Krueger, BA Graphic Design

3rd Quarter’s Newly Contracted Providers

Jeffrey Anderson, DDS Tigard, ORCole Anderson, DDS, MS Boise, IDN. Thomas Capsey II, DMD Medford, ORTravis McFee, DDS Salem, ORHamid Zehtab, DMD Lake Oswego, ORJason Bajuscak, DMD Portland, ORTyler Reading, DMD West Jordan, UTThomas Flath, DMD Portland, ORPeter Tommerup, DDS Grants Pass, ORGraham Hill, DDS Meridian, IDBradley Robertson, DDS Boise, IDScott Allen, DDS Idaho Falls, IDJay Harris, DDS Idaho Falls, IDMichael Elison, DMD Idaho Falls, IDJennifer Frankel, DMD Keizer, ORRiley Hicks, DDS Idaho Falls, IDJonathan Smith, DDS Spokane, WAJeffrey Travelstead, DMD Corvallis, ORH. James Clark, DDS Boise, IDEric Jacobsen, DDS Oregon City, OR

Please welcome the newest providers to the Advantage Dental Community.

“Intelligence without

ambition is like a

bird without wings.”

—Salvador Dali

18 | The Advantage 3rd Quarter 2013 | 19

VARIOUS LOCATIONS IN OR & WAPediatric Dentist: A Kidz Dental Zone/Advanced Pediat-ric Dentistry, a multi-site group practice in the Pacific Northwest, is looking for compassionate and motivated pediatric den-tists interested in opportunities to provide care focusing on prevention and community involvement We provide all the support our doctors need so that they can focus on building their community reputation and de-livering quality care in our state of the art clinical environments With us, a pediatric dentist can concentrate on patient care and patient care alone We offer a competitive salary with quarterly bonus potential, Health Savings Account, 401(K) retirement plan, company paid professional liabil-ity insurance, paid vacations and continuing education reimburse-ment The opportunity for future partnership is an option as well We currently have openings in Hood River, The Dalles and Herm-iston, Oregon and the Tri-Cities, Washington For inquiries please contact Dr J Kyle House at (541) 387-8688 or send resume to Jobs@akidzdentalzone.com

Orthodontist: Advanced Pedi-atric Dentistry, a rapidly growing Pediatric dental clinic currently

located in Pasco, Washington with a pending expansion to Richland, Washington, has an excellent opportunity for an or-thodontic provider Our practice is fully outfitted with state of the art equipment, a pediatric facility on one side of the facility and a dedicated orthodontic facility on the other The Orthodontic Practice is comprised of a ded-icated digital pan/ceph, 5 chair bay with a 6th chair in the exam/consult office, separate steriliza-tion facility and fully integrated computer network with Dolphin practice management software The clinics do share their lab, server, equipment and waiting rooms to decrease overhead This is an opportunity to practice fully integrated early and adolescent orthodontic care while building an adult base Our ideal candi-date should possess excellent clinical skills, a collaborative personality, have a community oriented practice philosophy and be licensed in both Washington and Oregon We offer a compet-itive salary based on experience with quarterly bonus potential, Health Savings Account, 401(K) retirement plan, company paid professional liability insurance, paid vacations and continuing education reimbursement To apply, please contact Dr J Kyle House at (541) 387-8688 or send resume to Jobs@akidzdental-zone.com

Classifieds

//STEP 1: INNOVATION IN SHAPING.

//STEP 2: INNOVATION IN IRRIGATION.

//STEP 3: INNOVATION IN OBTURATION.

© 2012 DENTSPLY International, Inc. ADENDO2 4/12 Rev. 1

IRRIGATING SOLUTION

//STEP 1: INNOVATION IN SHAPING.

//STEP 2: INNOVATION IN IRRIGATION.

//STEP 3: INNOVATION IN OBTURATION.

© 2012 DENTSPLY International, Inc. ADENDO2 4/12 Rev. 1

IRRIGATING SOLUTION

//STEP 1: INNOVATION IN SHAPING.

//STEP 2: INNOVATION IN IRRIGATION.

//STEP 3: INNOVATION IN OBTURATION.

© 2012 DENTSPLY International, Inc. ADENDO2 4/12 Rev. 1

IRRIGATING SOLUTION

Practices For SaleWHEELER, OR—Cash prac-tice with very low overhead and growing collections This 2 oper-atory practice shares the build-ing with a long-term care center, medical clinic, compounding pharmacy, physical therapist, and chiropractor

For more information, please contact Michelle Lauerman at michelleL@advantagedental.com

AssociateshipsBROOKINGS, OR–Full-Time on the beautiful Oregon Coast

Brief Job/Practice Description: We are a private office looking for a full time (4 days per week) dentist You will work with a well seasoned staff with two hygienists, 2 front office, and 2 - 3 assistants You will perform all aspects of general dentistry that you wish This is a fee for service office with no OHP You will be able to perform dentistry at the highest quality level Salary starts at $10,000 per month or 30% of production (not collection), whatever is greater The guaran-teed salary goes up depending on experience There is enough patient flow for you to earn more than $20,000 per month! There is also a signing bonus of $5,000, and a generous stay-on bonus after the first year and after the 2nd year There is the ability for frequent 4 day weekends If you wish, you can have every 5th week off (unpaid, however) To apply or receive more informa-tion contact:

Devin Brice DMD 1090 south 8th street, Coos Bay, Or 97420

Phone: 503-989-2921 Fax: 541-756-0760

Email: devinbrice@gmail.com

Equipment For SaleDENTAL EQUIPMENT FOR SALE:Local offers are preferred due to shipping costs If interested please call the Middle Creek Dental clinic in Nampa, ID at 208 466 7424 during normal busi-ness hours; or call Dr Christensen directly at 208 466 7424; e-mail at: middlecreek@qwestoffice.net

(1) ADEC 12 o’clock cabinets, $1, 000 ea

DENTAL EQUIPMENT FOR SALE—2 each, 2008 Forrest Dental Delivery Carts for Sale Used 1 year 5 hole instrument hose Self contained clean water system, Kavo fiber optics, heated syringes Cart features new U shape stand that is height adjust-able

$1500 or BO

1-2008 Forrest Dental Hygiene Delivery Cart: Used 1 year 5 hole instrument hose Self contained clean water system with heated syringe High speed suction and saliva Adjustable shelf

$1700 or BO

For for more information contact Sandy at Timm Family Dentist-ry at 541-382-1991 or sandy@timmfamilydentistry.com.

FOR SALE-BIOLASE ILASE LASER—The personal Laser for everyday soft tissue procedures

New Never Used, full warranty: Retail Value $4, 995

Offered at $4, 500

To inquire about this item cocn-

professionally maintained and uninstalled, $7500 or best offer Please contact drandy@tendercaredental.com for more information

FOR SALE:—Dentrix Im-ageCAM intraoral camera for sale: Unit is in perfect working order and takes great images Includes:

Camera Docking Station PC capture card and wireless foot pedal

$1500 or best offer

Additional docking stations are available for $500 or best offer per unit

Please contact drandyd@tendercaredental.com for more information

tact Dr Igor Shishkin at 541-326-8882 or email him at igorshish-kin@qwestoffice.net

DENTAL EQUIPMENT NEEDED (1) Mid Mark 11 auto clave,

(3) X-Rays 097Bel-Ray intra oral 31” arm with three pass through mounts,

(2) 1040 ADEC Radius Cascade chairs with 6300 radius lights with assistance radius arm

(1) Air Techniques A/T 2000 XR film processor,

(2) Bel-Med 5142-S Nitrous Oxide flowmeters with 4 yoke stand with rubber goods,

doctor stools assistance chairs and assistance tables

Please contact: jerrys@advantagedental.com

FOR SALE—Velopex Exra-X, x-ray Processor/developer (Day-light loader included): Unit is in perfect working order Processes and develops all types and sizes of dental films $1850 or best offer Please contact drandy@tendercaredental.com for more information

FOR SALE—2002 Belmont EX2000 Panoramic/Cepha-lometric X-ray unit: Unit is in perfect working order and was

Classifieds

NOTICE: Beginning September 1, 2013 Advantage Dental will no longer accept faxed, mailed, or emailed attachments for preauthorizations or referrals These attachments will need to be submitted, with the referral or preauthorization, through

ADIN If you do not have a scanner for this purpose in your office, Advantage Dental’s IT Department recommends the Epson v700 The cost is between $550-$700 These scanners can be found online at CDW or Newegg

Beautifully versatileto meet the needs of your practice.

Filtek™ Supreme UltraUltra Universal Restorative

Scotchbond™ UniversalAdhesive

www.3MESPE.com/Filtekwww.3MESPE.com/Scotchbond

Customer Care Center: 1-800-634-22493M, ESPE, Filtek and Scotchbond are trademarks of 3M or 3M Deutschland GmbH. Used under license in Canada. © 3M 2012. All rights reserved.

One composite can really do it all.

If only we could bottle versatility. Wait, we just did.

20 | The Advantage

January 2014

Poverty, SBIRT, Tobacco, and Prevention Training WebinarsJanuary 9th, 2014 from 12-1:30: Overview

January 30, 2014 from 12-1:30: The Culture of Poverty, Cindy Shirtcliff

February 6, 2014 from 12-1:30: SBIRT, Instructor TBA

February 27, 2014 from 12-1:30: Tobacco, Sharity Ludwig

March 6, 2014 from 12-1:30: Prevention, Gary Allen, Sharity Ludwig, and Cindy Shirtcliff

Calendar of Events

To Advertise in The Advantage Classifieds

Submit your ad for review to kimberlyk@AdvantageDental.com no later than 2pm the last Friday of the month prior to the end of the

quarter If you have any questions about advertising please call us at 866-268-9616

April 3rd and 5thOregon Dental ConferenceConvention Center Portland, OR

April 25th and 26thOregon Medical Association Annual MeetingThe Nines Hotel Portland, OR

August 1st & 2nd

Advantage Dental Summer MeetingEagle Crest Resort Redmond, OR

ACCOMODATIONS

503-644-3340Debbie Kutnyak, Beatty Group Int’l

REGISTER FOR CE

866-268-9616Kimberly Krueger, Advantage Dental

Presents

The CE is free for Advantage Dental Owners and their Staff and only $150 per office for all others.

Accommodations are at the Hyatt Regency Maui; 7 night double occupancy packages �art at $3,000 and include a mid-sized car, partial ocean view rooms with breakfa�.