Bundled Payments Integrating Dental Care May Reduce Emergency Department Costs

Objectives: Over two million U.S. patients visit hospital emergency departments for dental pain, costing $1.6 billion annually. We propose including dental coverage within medical bundled payments to improve dental care and reduce medical costs.

Methods: We constructed an economic model using a sample population of 500,000 patients based on nationwide averages for the frequency and cost of emergency department utilization for dental pain. The first model simulated yearly costs from status quo reimbursement policy. The second simulated yearly costs under a bundled payment model with dental coverage.

Results: The total approximated current cost for dental-related ED visits for a pool of 500,000 patients is $2.9 million annually. This represents $5.88 per-member-per-year for dental-related ED costs. A bundled payments strategy for the same model population costs $1.2 million annually, or $2.47 per-member-per-year for comprehensive emergency dental coverage.

Conclusions: The model showed that including dental coverage within bundled payments could both expand access to high-quality dental care and reduce health care costs associated with preventable emergency department visits.