Dental Health Associates, P.A.: Clifford G. Lisman, D.M.D., President and Chief Executive Officer

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Clifford-Lisman-thumbBased in New Jersey, Dental Health Associates, P.A., is spread across nine locations in the Garden State, with each location featuring full- and part-time general dentists, dental hygienists, and specialists who deliver a wide-ranging catalog of services, from episodic emergency care to boutique dentistry, to a patient base that ranges from infants to geriatrics.

In spite of having nurtured a significant infrastructure platform from which to grow, Clifford G. Lisman, D.M.D., president and chief executive officer, who founded Dental Health Associates, P.A., in 1986 after buying out his father’s practice, said he is “never satisfied and never happy” with remaining in one place as an organization or as an individual.

Having graduated from Rutgers University in 1975, he is again a full-time student at the university, where he is pursuing an MBA; professionally, Lisman has positioned Dental Health Associates, P.A., to carry on his father’s legacy into the healthcare reform era.

“Yes, the company is stable,” he said, “but also always evolving and changing. Stable should not be equated with static.”

Reaching an expanding Medicaid base

Dental Health Associates, P.A.’s current patient base is a mixture of Medicaid, capitation, PPOs, and full fee-for-service. Over the last five years, with the economy in a tailspin, Dental Health Associates, P.A., has undergone a rotational shift to increase its outreach to the NJ Medicaid and Family Care populations, the state’s version of the nationwide CHIP program.

In New Jersey, it is unusual for a provider to deliberately look to expand its presence among this patient base, but the program is gaining traction, Lisman said, with “significant hurdles” still existing “that deter the vast majority of providers from entering into the system.”

While this is a net positive for Dental Health Associates, P.A., it also presents a challenge both in educating this patient base on receiving the care they need and understanding and following federal and state regulations pertaining to documentation, claim submissions, and reimbursements.

Empowerment through education

Lisman said there is one pervasive factor that makes the education of Dental Health Associates, P.A.’s patient base difficult: “Unfortunately, most patients have the attitude that if it isn‘t covered by their insurance, it’s not necessary.”

As a result, Dental Health Associates, P.A., has to demonstrate the value of the services it provides and recommends, emphasizing the necessity of taking one’s care into their own hands, rather than allowing the insurance companies to determine their overall dental health and medical wellbeing.

Therefore, he said, “empowering providers, staff, and patients through education is a significant and ongoing project to have everyone understand the value of the services that we recommend and provide.”

The company’s efforts include multiple community outreach programs. Its marketing director and community coordinator spends a great deal of time in schools and at health fairs. Dental Health Associates, P.A., itself has put on major health fairs over the past years where they attracted over 1,000 people on average.

“We have providers from different offices come down, and we do dental screenings for people that come by,” Lisman said. “Last year, we opened it up, and we were providing free dental care for pregnant women as a means of spreading the word that pregnant women should undergo dental care on a routine basis and also to help educate and stimulate our providers that this is what they should be routinely doing as well.”

Revamping provider incentives for a changing market

As with the rest of healthcare, compensation within dentistry has been based upon production as opposed to patient satisfaction.

However, Lisman explained the oversight, monitoring, and measuring of procedures by third-party payers and federal entities has become just as intense within dental care as in the rest of healthcare, and the need to root out fraud, waste, and abuse is being heavily emphasized now. Furthermore, patient satisfaction scores are fast becoming a priority of the industry.

Dental Health Associates, P.A., is currently establishing a system wherein “providers’ compensation will also have a component tied into patient satisfaction, quality of care, compliance with protocols, and interaction among other staff members within the practice to enhance and further those types of behaviors that we’re looking for and to be ahead of the curve as to what’s coming down the pike.”

In many ways, Lisman added, he has an advantage in that he is intricately connected and networked with HMO and state officials, giving his organization an inside track on what’s happening and a multi-dimensional understanding of the rules and regulations that exist for the NJ FamilyCare population, as well as for other payers.

Lisman is also involved with the New Jersey Dental Association, the state Medicaid committee, and the New Jersey Oral Health Coalition. He serves on the quality management committee for United Healthcare and is a co-state leader for the Office of Head Start, helping to ensure that every head-start child is placed in a dental home.

“Many of the insurance companies often will call me or interact with me on protocols,” he said. When they don’t get it right, he is forced to correct them or in some cases, take them to court to legally demand compliance with federal and state mandates.

One company in particular, he said, has “now corrected most of the issues that I have alleged in the lawsuit that were problematic, but I am still going after them for damages.”

Committed to core values

Lisman said his company’s mission statement “is to achieve 100 percent patient satisfaction.”

Its three core focus values are achieving patient satisfaction and quality care; achieving employee satisfaction, growth, and development; and achieving practice growth and profitability.

“We must have all three in order to be successful and most fortunately all three work in a very symbiotic relationship with each other and they enhance each other,” he said. “Every once in a while, there is a conflict between one or the other, and if there is a conflict, we always resolve the conflict by one superseding two and two superseding three. And that’s how I make my business decisions and clinical decisions on a routine and daily basis.”

-by Pete Fernbaugh

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