Technology Follows Purpose
The Architectural Requirements Behind BOCA Prime
How BOCA Prime’s proposed responsibilities shape its technology choices, from identity and verification to payments, governance, and accountable automation.
Read paper →Understanding the system. Examining what could change.
Explore the evidence, design reasoning, and open questions behind BOCA—from the economics of dental care to the technologies and institutions that could support a different approach.
Explore the agenda ↓Cadmus Labs / BOCA Whitepaper
An integrated account of BOCA’s proposed model, development approach, and supporting architecture, bringing together the reasoning behind Direct and Prime.
Research agenda
Browse the questions Cadmus is investigating and the publications available to read. Findings will inform development and may change the assumptions behind the proposed model.
Available — ready to read. Commissioned — assigned for development. Planned — included in the future research agenda.
Research & analysis examines evidence. Design papers explain proposed approaches. Technical analyses compare systems and model their implications.
No papers match these filters.
The Current Dental System
Costs, coverage gaps, administration, and the pressures shaping dental practice.
Estimating the Administrative Burden of Dental Insurance in Independent Dental Practices
Examines the time, staffing, and financial resources independent dental practices devote to administering insurance.
Annual Maximums vs. Dental Costs: A Fifty-Year Comparison
Compares changes in annual dental benefit maximums with changes in dental treatment costs over fifty years.
The Dental Coverage Gap: Uninsured, Underinsured, and Paying Out of Pocket
Examines who lacks adequate dental coverage, what people pay themselves, and how financial barriers affect access to care.
Where the Dental Premium Dollar Goes: Care, Administration, and Margin
Examines how dental premium revenue is allocated among care, administration, and margin across available evidence and benefit structures.
Independent Dentistry Under Pressure: Ownership, PPO Economics, and Consolidation
Examines how ownership, PPO participation, reimbursement pressure, and consolidation affect independent dental practices.
The System Around the System: The Economic Cost of Healthcare Intermediation
Investigates the economic cost of organizations and services surrounding healthcare transactions, including the functions they perform and potential duplication.
Dentist Earnings and Insurance Reimbursement: Are Dentists Being Paid Less in Real Terms?
Compares dentist earnings and insurance reimbursement with inflation, staffing, technology, and other costs of delivering care.
The Dental Workforce Pipeline: Are Economics Changing Who Enters, Stays in, or Leaves Dentistry?
Examines dental education, practice entry, ownership, retention, retirement, and geographic supply in relation to professional economics.
Membership & Practice Economics
Membership models, software, and the economics of sustained practice participation.
Membership Dentistry: Adoption, Economics, and Operational Limits
Reviews adoption, practice economics, patient participation, and operational limits of dental membership plans.
The Dental Membership Infrastructure Market: Vendors, Pricing, and Unmet Needs
Compares dental membership software providers, pricing, capabilities, and unmet practice needs.
The Practice Economics of Prevention, Recall, and Membership
Examines the relationship between prevention, recall, membership participation, and the economics of running a dental practice.
Evidence Before Expansion: Why BOCA Begins with Direct
Explains Direct’s role as BOCA’s first commercial product and how practice relationships and operating experience can inform broader development.
Coverage & Affordability
Benefit models, payment, financing, and the resources needed to support care.
From Administrative Work to Protocol Execution: What Could a Deterministic Dental Coverage System Actually Remove?
Identifies which administrative tasks rule-based coverage could eliminate or simplify, and which responsibilities would remain.
Why Does Dental Payment Take So Long? Mapping Friction Between Care and Payment
Maps delays between treatment and payment, including the onboarding, verification, and payment requirements that shape practice participation.
How Predictable Is Dental Utilization? Implications for Rule-Based Coverage
Evaluates patterns and uncertainty in dental utilization and what they imply for coverage rules, costs, and risk.
Alternative Healthcare Financing and Expense-Sharing Models: Crowdfunding, Mutuals, Reciprocals, and Regulated Risk Bearing
Compares alternative healthcare financing and expense-sharing arrangements, including their economic structures, responsibilities, and regulatory boundaries.
The Dental Financing Market: Affordability Gaps and the Case for Rootline
Examines existing dental financing options, affordability gaps, and whether an additional financing service could meet a meaningful need.
Public Dental Benefits as Infrastructure: Where New Rails Could Reduce Friction
Examines where changes to eligibility, verification, administration, and payment infrastructure could improve public dental benefit delivery.
Financing the Dental Coverage Gap: What Efficiency Can Solve—and What Still Requires Capital
Evaluates how far administrative efficiency could improve dental affordability and which funding needs would remain.
Dental Benefit Models: Comparative Economics, Regulatory Classification, and Implications for BOCA Prime
Compares dental benefit models through common treatment scenarios, examining economics, patient and provider experience, and regulatory classification.
From Novelty to Legal Category: How New Health-Benefit Models Became Regulated
Traces how unfamiliar health-benefit models became recognized or regulated, with a focus on California and selected comparisons.
Consumer Value, Dental Preparedness, and Alternative Contribution Mechanisms
Investigates perceived value, trust, and flexible contribution mechanisms to determine whether they could improve participation and dental preparedness.
Moving Verification Upstream: Designing for Pre-Established Certainty in Dental Payments
Explores how establishing necessary facts earlier could reduce repeated verification and uncertainty between care and payment.
Reserve Design Principles for BOCA Prime
Develops principles for reserves, liquidity, and financial resilience within BOCA Prime’s proposed coverage model.
Participation Incentives and Long-Term Alignment
Examines how proposed participation incentives could support lasting value for patients, practices, and the wider system.
Technology & Clinical Data
Identity, AI, financial infrastructure, and the responsible use of dental information.
Technology Follows Purpose: The Architectural Requirements Behind BOCA Prime
Explains how BOCA Prime’s proposed responsibilities shape its technology choices, from identity and verification to payments, governance, and accountable automation.
Read paper →AI-Assisted Dental Diagnosis, Treatment Planning, and Professional Learning: Capabilities, Evidence, Risks, and Validation Requirements
Reviews evidence for AI-assisted dental case analysis, diagnosis, treatment planning, and professional learning, including validation and oversight requirements.
Tokenized Financial Infrastructure for Dental Coverage: Capital Efficiency, Liquidity, Settlement, and the Limits of Tokenization
Compares conventional and tokenized financial infrastructure for contributions, reserves, liquidity, and settlement, including costs and operational tradeoffs.
Patient-Controlled Dental Records and Data Portability: Access, Interoperability, Provenance, Privacy, and Clinical Value
Examines whether portable dental information could improve continuity of care, and the access, interoperability, privacy, and provenance requirements involved.
The Learning Health Network for Dentistry: Building the Infrastructure for Continuous Clinical Evidence
Investigates how appropriately governed information from routine dental care could support reliable longitudinal research and clinical learning.
Rootprint: Design Objectives for Continuity, Identity, and Attested Care
Sets out Rootprint’s proposed objectives for persistent identity, continuity, provider attestations, permissions, and verifiable information.
DentAI Within BOCA: Design Boundaries for Clinical-Evidence Verification, System Integrity, and Human Review
Defines DentAI’s proposed role in evidence verification, anomaly detection, escalation, and human review within BOCA.
Where Does Verifiable Infrastructure Earn Its Place? A Requirements-Based Architecture Analysis for BOCA
Compares conventional and specialized infrastructure against BOCA’s requirements to identify where added complexity provides a material advantage.
Governance & Institutional Design
Capital, authority, and the structures that shape whom a system serves.
Capital, Governance, and Institutional Capture
Examines how capital, ownership, and decision rights shape institutional behavior, and which structures may preserve purpose and participant agency.
Governance Principles for a Conditional Future Coverage System
Develops principles for decision rights, accountability, participant involvement, and changes to BOCA Prime’s proposed rules.
This agenda will evolve. Topics may be added, combined, revised, or retired as the work develops.
Contribute to the research.
Have relevant evidence, experience, or a question we should examine? We welcome contributions from researchers, clinicians, and other specialists.
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