Pay-for-performance in dentistry: what we know

J Healthc Qual. Jan-Feb 2010;32(1):51-8. doi: 10.1111/j.1945-1474.2009.00064.x.


Little is known about the effect of a pay-for-performance system (P4P) on primary medical care providers and even less is known about its potential impact in dentistry. Based on the growing acceptance of performance-based reimbursements in medicine and the dissemination of innovative technologies, structures, and processes of care from medical to dental services, it is likely that the dental profession will face performance-based payments in the not-too-distant future. In this paper, we present the current experience of P4P in primary medical care that has relevance to dentistry and discuss the dental performance-based programs to date. Taking into consideration these lessons, the structure of dental service delivery in the United States, and the paucity of evidence-based quality indicators in dentistry, we provide several guidelines for the design of P4P pilot programs for dental services. We conclude that large-scale implementation of P4P for dentistry may not be a realistic option before significant progress is achieved in quality of dental care indicators.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Dentistry / standards*
  • Health Policy
  • Humans
  • Quality Assurance, Health Care / economics*
  • Quality Indicators, Health Care
  • Reimbursement, Incentive*
  • United States