This promising practice is shared by
Bluestem Health in Lincoln, NE
In July 2018, Bluestem Health applied for the Safety Net Solution In-Kind Dental Program Technical Assistance. This opportunity was first brought to our attention by Jenna Thomsen, Director of Training and Technical Assistance at HCAN. Bluestem Health’s dental clinic was one of ten programs selected to receive this technical assistance. The process included:
  1. Practice Analysis (practice management data survey, key practice data, site visit)
  2. Findings and Discussions (presentation, discussion, strategy)
  3. Improvement Plan (action steps, road map, timelines)
  4. Supported Implementation (coaching, guidance, motivation, accountability)
Beforehand, we were required to submit key practice data. The whole process was run very efficiently. Dr. Russell and Caroline from Dentaquest served as project managers. They came for a site visit and met with dental staff, billing staff, and the leadership team. Bluestem is currently in the ‘Improvement Plan’ stage, with some action steps completed and some in progress. This technical assistance will end February 15th, 2021. The advice that I would give other dental programs considering this process is to apply. We received helpful guidance from Dr. Russell and Caroline and gained access to resources such as templates, advice, reminders, and otherwise. Getting your dental program evaluated from an outside perspective is helpful and can result in a cascading effect of other positive outcomes similar to what Bluestem experienced, such as the HRSA grant and revenue cycle analysis technical assistance from HCAN.
Name something unique about the work completed:
Sometimes we do not think outside the box because we just keep on working and doing the same things over and over again. Bluestem Health Dental clinic was constantly looking to expand the dental program outside the main location thinking that we do not have space for expansion at the main clinic. Dr. Russell revealed to us during the site visit that we can indeed expand here by moving our dental front desk and dental waiting area to the large medical side lobby and build two dental operatories in that space. As soon as the HRSA Oral Health Infrastructure grant came along we were ready to act on this renovation project and were awarded the grant.
List lessons learned:
1. We were not collecting co-pays upfront for restorative visits for commercial insurance patients before the site visit. Now we are collecting all the co-pays upfront for restorative visits.
2. We were offering up to 3 dental appointments per patient which caused lot of back log in our scheduling and increased our no-shows. Per Dr. Russell’s recommendation we started giving only one appointment at a time and once the patient showed up for that appointment we give another one. This unclogged our scheduling and opened up lot of slots for other patients.
3. Staffing issues: We were short staffed at the dental front desk and sterilization. As per Dr. Russel’s recommendations we were able to add these two new positions for this year’s budget.
4. We were seeing too many new patients and were not able to complete their treatment plans in a timely manner. Now we are tracking the treatment plan completing rate.
5. Billing and Revenue cycle analysis weakness were identified at the site visit. We got TA assistance from HCAN to get Coding and Compliance Initiatives, Inc to do Revenue Cycle analysis and give us recommendations on improving our program.
Please list clinical outcomes/results from this project:
1. We got a HRSA grant to add two new dental operatories which was directly related to the recommendations from site visit.
2. Revenue cycle analysis was done from Coding and Compliance Initiative which came about because Jenna from HCAN was present during the final presentation of site visit and offered TA from HCAN.
3. We are tracking Treatment completion rate from the guidelines Dentaquest gave us.
4. We are focusing more on medical-dental integration and prioritizing children, pregnant patients, patients with diabetes, etc
Please list any future plans:
1. Follow Revenue cycle analysis site visit recommendations
2. Medical-dental integration
3. To increase treatment completion rate up to 80%
Submitted by:
Dr. Reddy
Bluestem Health