AtlantiCare plans to continue investing in dental services once it opens its first dental clinic in February, according to President and CEO Michael Charlton.
The practice, which will be located in Atlantic City, is part of the health system's federally qualified health center program. AtlantiCare aims to reduce the number of dental-related emergency department visits and enhance holistic care for patients.
AtlantiCare joins several other health systems that have recently invested in dental services to advance medical-dental integrated care.
Mr. Charlton recently spoke with Becker's to discuss the new dental clinic and AtlantiCare's plans for expansion in dentistry.
Editor's note: Responses were lightly edited for clarity and length.
Question: What does this new dental clinic mean for AtlantiCare?
Michael Charlton: At the macro level is the power of the FQHC. If you look at where this particular dental practice is opening up, it's a community of 38,000 mostly uninsured and underserved populations and the FQHC provides a tremendous amount of primary care and specialty care to those recipients. So this was just a natural progression of continuity of care for our patients. The dental component for children and then moving into the adult population is critical. We know that good oral hygiene, especially for young kids, is critical, but we also know for our aging population that dental hygiene is critical in the sense that it's a primer for cardiovascular disease and some of the other comorbidities that our patient population has. So not having access to those services is obviously not something that we were ever happy about and finding a way now to be able to deliver cost-effective care to that population has been incredibly rewarding.
Q: How have dental-related emergency department visits affected AtlantiCare?
MC: When you look at the population we're looking to serve — we're potentially going to see 3,000 patients annually and 8,000 visits — and then you talk about the primary preventive dental care, without those services being provided, you understand that delayed care is ultimately going to end up with challenges for our population. So we may see you in the ED over several things, but the opportunity there to have bad oral care or a lack of oral care obviously presents in the ED. It becomes critical to how we then correct some of those actions. In that population with the lack of resources, it becomes incredibly difficult to make sure they're following up on their care.
Q: When did AtlantiCare become interested in offering dental services?
MC: It's been an incredibly long process. These conversations started way back probably in 2016 or 2017 with the Casino Reinvestment Development Authority. So the building where this is housed also houses primary care and a bunch of other services for the community that are all listed under the FQHC. Dental was something that we always had aspirations around and we had the space programmed into it. So we started the conversation with state and federal legislators understanding what kind of federal or state money would be there. We had some real support at the state and federal level. Once we got the green light on building the building and building out the programming [for] these services, we were very committed to the dental program. So we received a grant of almost $1 million to fund the adoption of this program. But it was a good three or four years in the works before we actually got the doors open.
Q: Are health system executives starting to realize the link between oral health and overall health?
MC: I think [that's] absolutely correct. I think we've always known it. The challenge has been how do we get it up and standing? How do we fund it and then how do we connect it to the rest of the health system? The data is clear, specifically now about cardiovascular disease [and] diabetes, that great oral care taught young [and] persistent through the rest of your life [can] prevent some of these other challenges that you have as you age.
Q: Are there any other dental-related initiatives that AtlantiCare has in the works?
MC: As we do everything, we're going to start small. We're gonna start organically. We're going to make sure we're delivering great access, great patient care and great outcomes, and then we'll build the program from there. [There is] a great need through the community and there are other parts of the community that would be well-served by this practice for the underinsured and uninsured population. So obviously our aspiration would be to grow this program in those areas where we can have the best impact and make sure that they have the same access as our insured population.
Q: What kind of outcomes does AtlantiCare hope to see from the clinic?
MC: Right now, it's not about return on investment. It's about making sure that we have continuity of care and we're providing the right care in the right place to a constituent of our community that doesn't have this. Typically it's been taboo when you start aligning patients by the economics or how they're insured, but the epiphany was the FQHC and how that is financed is the right place for a large segment of our patient population because it has that additional payment option which allows you to wrap resources such as dental and the social determinants to health, whether it's food insecurity [or] housing. There's a multitude of things we can do at the FQHC that you can't do in a regular primary care practice or a specialty or subspecialty [practice]. We're really exploring those options and I think dentistry is the first offshoot of that.
Q: Do you expect to see any challenges with staffing and or meeting patient demand?
MC: Not with the new venture because we've done a good job of recruitment and we have people who are tied to the purpose of what we're trying to do. So that's the positive, but we're not immune from the other challenges that other systems have or that dentistry has. We're still facing those challenges, whether it's compensation, recruitment [or] retention ... I don't think there's any particular service line or program that's immune from it and dentistry sits in that same bucket. [But] we're fully staffed, ready to go. The program director is there, our first physician is on site. He's been an integral part of the program. Our second physician will be there in about a week. So the team is all ready to go.