Access Dental Care Delivers For PACE of the Triad 

Written by Dr. Bill Milner, President Access Dental Care (June, 2015)

CaptureEllen Smith, BS, RN, PACE of the Triad Center Manager, had seen the problem before.  As former supervisor for a hospice and palliative care agency, her patients needing dental care had to be shuttled from home to a local dentist and back home again.  What made matters worse, the caring dental staff was afraid to treat some of her fragile patients, wanting to refer them to a specialist in the area.  It was a wasted trip, a terrible use of resources and resulted in a patient still needing basic dental services.  Oral health, neglected during the illness process, was becoming an irritating source of pain and infection.

Ms. Smith had heard about Access Dental Care (ADC) through her nursing home contacts.  She knew this non-profit special care dental organization provided onsite care to skilled nursing facilities, group home day centers and HIV/AIDS patients in the surrounding area.  Could this be the answer for PACE of the Triad, a Program of All-inclusive Care for the Elderly responsible for providing comprehensive health care services?

“It was just too easy,” Ms. Smith said.  “ADC’s staff moved their two operatories of dental equipment into the clinic area and started treating PACE patients, many of whom had not seen a dentist in years.  Instantly, comprehensive dental services were now an integral part of our care routine.  We knew that poor oral health caused aspiration pneumonia, heart problems, septic issues, diabetes and cancer related complications.  Our job of managing the patient’s total health was now supported by these dental long-term care experts.”

“ADC now comes two to three days a month and is a phone call away for emergencies.  Not only do they handle the difficult-to-treat patient, but they know how to communicate with responsible parties, explain treatment plans and include them in the decision making process.  They continue to see twenty plus patients a day, take x-rays, clean teeth, provide fillings, extract teeth and make dentures.  The patients simply roll or walk into the clinic, get the care they need and then go back to their daily activities.”

How did the contract work?

ADC had always charged nursing facilities a retainer fee plus billed Medicaid and private pay patients on a fee-for-service basis.  The retainer fee allowed the organization to break even, compensating it for daily transportation to facilities, billing and communication with responsible parties and the emergency on-call service.  Ms. Smith stated that “we started out with the same approach, but because we were paying for the individual services, our team had to review and approve every treatment plan.


Patient Care at PACE of the Triad by members of the Access Dental Care Team

This was cumbersome for us and in some cases delayed treatment for patients.  Then I thought, we are on a capitated system, why not ask ADC to price out their services the same way?”  ADC did the numbers and determined their break-even cost per patient per month.  This included all services, even dentures.  Ms. Smith said, “This solved the problem.  ADC was extremely flexible as we added new patients, making sure that the per capita rate matched up with the amount of time they were spending taking care of patients.  Their main focus has always been quality care while being fairly compensated.”

Ms. Smith is proud of the program.  “Early on, PACE of the Triad made the strategic decision that the mouth was going to be part of the body in our comprehensive approach to health care.  Our future patients, being much more preventive minded, will expect routine dental care.  We feel good knowing that we have a program in place to serve their needs.”


Want to know more about Access Dental Care?  Visit their website, or call their Asheboro office at 336-626-7232. For information about PACE of the Triad, visit or contact 336-550-4046.