Market Trends: Sizing Up Dental Sleep Accreditation
American Academy of Dental Sleep Medicine (AADSM) accreditation distinguishes a facility as functioning at a high level of competency and care. In doing so, accreditation assures patients, medical professionals, and reimbursement decision makers of an organization’s dedication to quality performance and excellence in every aspect of business—from a patient’s treatment and ongoing care to the staff’s commitment to continuing education and attention to detail. Last year, the AADSM announced that eight more dental sleep medicine facilities added the credential to their resumes, bringing the current total of accredited facilities to 26.
Sleep Review spoke with three dental professionals whose facility earned AADSM accreditation. Michael Simmons, DMD, Jamison R. Spencer, DMD, and Steven C. Scherr, DDS, told Sleep Review why they decided to undergo the accreditation process, what being accredited means to them, and what benefits it brings to their practices.
Sleep Review: What expectations do you have from accreditation?
Michael Simmons, DMD: I had little initial expectation from accreditation other than a personal/business accomplishment validating the quality of dental sleep medicine care that my facilities provide. In the future, my expectation is that other health care professionals, as well as patients and insurance carriers, will recognize accreditation as an indicator meriting their referral, scheduling of appointments, and insurance reimbursement for services provided. As such, my long-term expectation is increased flow of patients seeking standardized quality dental sleep medicine health care.
Jamison R. Spencer, DMD: I hope to increase the knowledge among physicians in my community that some dentists are going to great efforts to be experts in the field of dental sleep medicine, and that working with these dentists will result in better treatment outcomes.
Steven C. Scherr, DDS: Accreditation is an increasingly accepted quality indicator for delivery of a wide range of health care services. Our physician partners who refer their sleep-related breathing disorder patients for oral appliance therapy, their patients, and interested third-party payors deserve to have a means of identifying qualified dental practitioners. Accreditation recognizes those licensed dentists who have voluntarily demonstrated a measurable level of competency by meeting or exceeding a set of standardized requirements designed to improve quality of care. Each accredited facility is overseen by a single dental director and agrees to follow all AADSM practice protocols and American Academy of Sleep Medicine (AASM) practice parameters. As an increasing number of facilities seek accreditation, I am confident that AADSM dental sleep medicine facility accreditation will be considered the gold standard for ethical, competent, collaborative, and compassionate dental sleep medicine services.
Sleep Review: Tell me about your decision-making process. Did you have any hesitation about pursuing the accreditation? If so, why?
Simmons: I considered the cost, effort, and potential outcome and initially hesitated to take this journey. After more thought, it appeared an important step to prove to myself and to others my commitment to this health care field. It is very different to self-proclaim one’s expertise as opposed to demonstrating expertise that is validated through credentialing by an independent body that applies impartial criteria. Additionally, accreditation speaks to more than just the facility director and their qualifications; it also speaks to the type of patient-centered care provided, the required follow-up, feedback, and built-in quality control. Accreditation demands systems and controls in providing care. The result is a better and more consistent delivery of dental sleep medicine health care.
Spencer: No, I thought it was a great idea. My practice has been limited to temporomandibular disorders and sleep for 15 years. This was a way to show a higher level of commitment and seriousness. Any dentist can fit an oral appliance, but that doesn’t mean the treatment outcome will be the same.
Scherr: None at all. When I first learned in the spring of 2010 that an accreditation program was under consideration, I was eager to become involved in the process. I saw accreditation as a way to develop a framework for organizing our office systems focused on mitigating the patient’s sleep apnea condition and helping to improve their quality of life. Preparation for accreditation was a lot of work; self-examination always is, but the rewards in staff development, organizing safety procedures, and developing a comprehensive policy and procedures manual have been gratifying. The expert staff at the AADSM offices in Chicago, especially Carolyn Winter-Rosenberg and Randi Prince, have gone above and beyond in simplifying the process for us and helping to streamline compliance. I’m very proud to be the dental director of the very first dental sleep medicine facility ever accredited by the AADSM.
Sleep Review: What was the accreditation process like?
Simmons: The accreditation process consisted of a significant amount of paperwork and documentation with an organizational focus. After the purchase of a CD/workbook and recruiting staff, the journey began. The evaluative process culminated in a virtual site visit to check on patient records and confirm that treatment that had been provided had followed the required parameters. From beginning to end, the process took approximately 1 year.
Spencer: I thought it went very smooth. I feel that the process was well thought out and thorough. Any process has problems and can improve, but for an initial offering, I thought the AADSM did a great job. I assume this is partly due to the fact that the AASM has been providing accreditation for sleep labs for years and the AADSM was able to benefit from this experience.
Scherr: Accreditation is a journal that provides regular mileposts for ethical, safe, and effective dental sleep medicine professional activities. The journal itself is our policy and procedures manual. Having everything written down helps to improve consistency and relieves stress by having a plan already in place should an emergency or other unanticipated event take place. Accreditation raised the bar and, with it, expectations. At various times, preparing for accreditation was tedious, overwhelming, exciting, but mostly gratifying. It was reassuring to learn that we were already doing so many of the right things; we just needed to become better organized.
Sleep Review: Did you have to make any changes at your facility to meet the accreditation standards?
Simmons: There was additional use of forms from intake through patient feedback. Supplemental record keeping became an ongoing component that is required to maintain accreditation. Staff also was required to be trained and knowledgeable. While all this may initially affect efficiency, it results in better patient care and the resultant patient feedback enables facilities to improve to new levels.
Spencer: Overall, we had most of the systems in place already. However, it was very helpful to go through everything and see what needed to be updated.
Scherr: One requirement that stands out is the need to survey treated patients in order to measure quality control. At first glance, this just seemed like more useless paperwork. However, I have to admit that patient surveys have become a great motivator—almost addictive. Patient comments have been overwhelmingly positive and serve as a terrific motivator for each staff member.
Sleep Review: How do you feel accreditation has benefited your practice?
Simmons: Members of our accredited facilities are proud of achieving accreditation and have increased self-confidence, especially knowing that we are leaders in our field. Patients also have increased confidence in the care we provide and are comforted by their opportunities to give written feedback.
Spencer: We now know that all of our dental sleep-related systems are up to date and exact. We believe that our accredited sleep labs will respect the process that we had to go through to become accredited.
Scherr: We’re continuing to earn greater recognition as a discipline. Accreditation provides a pathway for excellence from a nonbiased, independent, and nonprofit organization that assures our patients and referring physicians that there is standardization of care at this facility, where they will be treated with expertise in a compassionate and professional manner. I am proud to be on the forefront of that process.
Sleep Review: Does accreditation help you with insurance reimbursement? If so, how?
Simmons: There is no benefit at this time with regard to insurance reimbursement for an accredited dental sleep medicine facility. However, there are certainly insurance differences shown toward accredited medical sleep facilities. If changes do occur in dental sleep medicine with regard to insurance reimbursement, my facilities are at least well positioned.
Spencer: It may. There are some insurance companies that look for things like accreditation. However, since this is so new, I believe that accreditation may become more important a few years from now.
Scherr: Dental sleep medicine facility accreditation is still in its infancy. Since our facility became the first to be accredited in November 2011, there has been encouraging growth in incoming accreditation applications. There are already nearly 30 AADSM dental sleep medicine facilities that have been granted accreditation nationwide. The future value of accreditation can be extrapolated from other accreditation programs. Payor recognition has come with the growth in the number of accredited facilities. Some plans even recognize accreditation status as a coverage criterion for applicable equipment and services. Dental sleep medicine facility accreditation is unique in the health care arena, in that it recognizes proficiency outside of the hospital setting, for both the facility and the provider of durable medical equipment. Even though I know of no current third-party payor dental sleep medicine accreditation requirement, being accredited is one more indication of gold standard care.
Sleep Review: In what way do you feel accreditation will set you aside from your competition?
Simmons: Accreditation validates one’s commitment to providing quality dental sleep medicine care and to sustaining certain agreed upon standards. If you were a patient seeking dental sleep medicine care, this might be important enough to you to seek out such a facility. In the end, I predict dental sleep medicine care and its availability will reach a point where patients will demand the level of care as dictated by specific standards. Those facilities that have such recognition will be better positioned to provide this care.
Spencer: Again, any dentist can fit an oral appliance for sleep apnea. However, very few are willing to go to the lengths that we have to obtain the education and experience to provide the excellent care that we do. Accreditation is just an outward sign of the inner commitment that we have to excellence.
Scherr: As a member of both the accreditation committee and Board of Directors of AADSM, my goal is to help elevate other facilities to the gold standards established by the accreditation program. Accreditation recognizes knowledgeable, safe, and effective practices. Obstructive sleep apnea is a pervasive disorder. Nothing would make me more proud than to have hundreds of newly accredited facilities throughout the country and to know I may have made some small difference in their development. SR