PRACTICE
as PPO providers. It’s a basic supply and demand principle. The more providers willing to take a cut in reimbursement rates, the more the rates get cut. Rates will only go up if there is a drop in the number of willing network providers. As long as network provider numbers are healthy, reimbursement rates will continue to drop. As The American Dental Associations Health Policy Institute (HPI) has recently shown, the trend of reimbursement decline has been steady for several years. Inflation and Cost of living haveTHE increased, yet dental reimbursement ratesROOM continue to decline. ELEPHANT IN THE
There has been a lot of discussion and social media chatter recently, in regards to dental office frustrations with dental insurance companies. There has been hope that some entity can come in and rescue them from compromises they have agreed to over the years by signing up as PPO providers. With inflation and COVID caused increases to overhead, dental offices are finding themselves at the crossroads, where expenses can no longer be met at the reimbursement rates currently of dentists sign up a PPO provider has been The rates. willingness of dentists to signThe up willingness as a PPO provider hastobeen theasmain cause of overall offered by many PPO reimbursement the main cause of overall dental reimbursement decline. Not all dental reimbursement decline. Not all dentists are willing to sign on for a cut in reimbursements. dentists are willing to sign on for a cut in reimbursements. On Oncan thebe graph below, it is known that Montana Dentists traditionally do not sign on with PPO The decline in reimbursement rates directly attributed to the graph below, ithave is known that Montana Dentists traditionally plans. reimbursement rates in Montana increased while most of the nation has the number of dentists signed up as PPOTherefore, providers. It’s a basic do not sign on with PPO plans. Therefore, reimbursement decreases supply and demand principle. Theexperienced more providers willingintodental reimbursement. Utah is well below the national average in rates in decline Montanaoccurring have increased while most the nation to the therates amount of reimbursement over the past fewofyears. This is take a cut in reimbursement rates,regards the more get cut. has experienced decreases in dental reimbursement. Utah is related to aofhigh number of dentists on PPO plans. Rates will only go up if there is adirectly drop in the number willing well below the national average in regards to the amount of network providers. As long as network provider numbers are reimbursement decline occurring over the past few years. This is healthy, reimbursement rates will continue to drop. directly related to a high number of dentists on PPO plans. Our state has one of the highest percent of solo practitioners in As The American Dental Associations Health Policy Institute the nation. The number of dentists per 100,000 population is (HPI) has recently shown, the trend of reimbursement decline has dropping in Utah. Young dental students have a huge debt load been steady for several years. Inflation and Cost of living have coming out of dental school. Dental income in Utah needs to increased, yet dental reimbursement rates continue to decline. improve going forward, or we will have a hard time keeping a young dentist that decides to practice in Utah. One way to increase dental income is by decreasing PPO dependence. Dental incomes will increase if PPO participation decreases. See the current national dental earnings graphic below. This is the Elephant in the room. If you want to improve your individual position and help contribute to an overall effort to improve dental reimbursement, take a look at which PPO plans you are contracted with. Evaluate if it is wise for you to continue the downward trend with this PPO. Ask your Office manager, they
Our12state has one of the highest percent of solo practitioners in the nation. The number of dentists per 100,000 population is dropping in Utah. Young dental students have a huge debt
January / February 2022
